Literature DB >> 27566605

Comparative benefits of laparoscopic surgery for colorectal cancer in octogenarians: a case-matched comparison of short- and long-term outcomes with middle-aged patients.

Koki Otsuka1, Toshimoto Kimura2, Masanori Hakozaki2, Mizunori Yaegashi2, Teppei Matsuo2, Hitoshi Fujii2, Kei Sato2, Tomoki Hatanaka2, Akira Sasaki2.   

Abstract

PURPOSE: The aim of this study was to compare the postoperative short- and long-term outcomes after laparoscopic colorectal surgery (LCS) between octogenarians and healthy middle-aged patients.
METHODS: Between January 1997 and July 2009, 655 consecutive laparoscopic surgeries for colorectal cancer patients were operated by 1 colorectal surgeon. Ninety-three patients were octogenarians (≥80 years), and 133 patients were case-matched middle-aged (60-69 years) patients. We analyzed the mean operative time, blood loss, type of surgery for rectal cancer, length of hospital stay, mortality, and morbidity. The overall survival curve was constructed using the Kaplan-Meier method.
RESULTS: The American Society of Anesthesiologists classification was significantly higher in the octogenarians than in the middle-aged controls. However, there were no significant differences between the two groups in terms of the incidence of morbidities (11.7 vs. 9.2 %) and length of hospital stay (12.1 vs. 10.9 days). The number of lymph nodes harvested was significantly fewer (p < 0.05) and the operative time significantly shorter (p < 0.05) in the octogenarians than in the middle-aged controls. At a mean follow-up of 38.2 months, the overall 5-year survival rate was 64.8 % in the octogenarians and 92.4 % in the middle-aged group, whereas the cancer-specific 5-year survival rate was 91 % in the octogenarians and 95.7 % in the middle-aged group.
CONCLUSIONS: We suggest that advanced age should not be a contraindication for LCS, even for complex procedures, such as laparoscopic rectal resection.

Entities:  

Keywords:  Colorectal cancer; Comparative study; Elderly; Laparoscopy; Octogenarian

Mesh:

Year:  2016        PMID: 27566605     DOI: 10.1007/s00595-016-1410-9

Source DB:  PubMed          Journal:  Surg Today        ISSN: 0941-1291            Impact factor:   2.549


  34 in total

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Review 5.  [Laparoscopic surgery for benign colorectal diseases].

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7.  Australasian Laparoscopic Colon Cancer Study shows that elderly patients may benefit from lower postoperative complication rates following laparoscopic versus open resection.

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9.  Laparoscopic colorectal surgery in elderly patients: a matched case-control study in 178 patients.

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Authors:  Dennis Hong; Mark Lewis; Jeanine Tabet; Mehran Anvari
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Review 1.  Management of locally advanced rectal cancer in the elderly: a critical review and algorithm.

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3.  Age and comorbidities do not affect short-term outcomes after laparoscopic rectal cancer resection in elderly patients. A multi-institutional cohort study in 287 patients.

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  4 in total

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