Yujiro Nishizawa1, Taishi Hata2, Ichiro Takemasa3, Makoto Yamasaki1, Hiroshi Akasaka4, Ken Sugimoto4, Koki Tamai1, Hidekazu Takahashi1, Naotsugu Haraguchi1, Junichi Nishimura1, Chu Matsuda1, Tsunekazu Mizushima1,5, Masakazu Ikenaga6, Hirofumi Yamamoto1,7, Kohei Murata8, Hiromi Rakugi4, Yuichiro Doki1, Masaki Mori1. 1. Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Yamadaoka 2-2, Suita, Osaka, 565-0871, Japan. 2. Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Yamadaoka 2-2, Suita, Osaka, 565-0871, Japan. thata@gesurg.med.osaka-u.ac.jp. 3. Department of Surgery, Surgical Oncology and Science, Sapporo Medical University, Sapporo, Japan. 4. Department of Geriatric and General Medicine, Graduate School of Medicine, Osaka University, Suita, Japan. 5. Department of Therapeutics for Inflammatory Bowel Diseases, Graduate School of Medicine, Osaka University, Suita, Japan. 6. Department of Gastroenterological Surgery, Higashiosaka City Medical Center, Higashiosaka, Japan. 7. Division of Health Sciences, Graduate School of Medicine, Osaka University, Suita, Japan. 8. Department of Surgery, Suita Municipal Hospital, Suita, Japan.
Abstract
BACKGROUND: The number of elderly patients with colon cancer is increasing in Japan. Postoperative delirium (POD) is a major complication for elderly patients who undergo surgery, and postoperative pain is a common inducer of POD. We reported previously that single-incision laparoscopic surgery (SLS) significantly reduces postoperative pain compared to conventional laparoscopic surgery (CLS). Data are lacking about the effect of SLS on POD. This retrospective study evaluated the clinical benefits of SLS for POD in elderly patients with colon cancer. METHODS: This retrospective case-control study included colon cancer patients (n = 134) over 75 years old who underwent elective surgery from 2009 to 2015 at Osaka University Hospital. Of these patients, 110 were evaluated using the comprehensive geriatric assessment (CGA) before surgery and were classified into lower or higher risk groups based on their scores. RESULTS: The rate of POD was significantly lower in the SLS group than the CLS group (13.8% vs. 30.0%; p = 0.0161). In the CGA-based higher risk group, the rate of POD was significantly higher in the CLS group than the SLS group (p = 0.0153). CONCLUSIONS: SLS for elderly colon cancer patients may lower the incidence of POD compared with CLS.
BACKGROUND: The number of elderly patients with colon cancer is increasing in Japan. Postoperative delirium (POD) is a major complication for elderly patients who undergo surgery, and postoperative pain is a common inducer of POD. We reported previously that single-incision laparoscopic surgery (SLS) significantly reduces postoperative pain compared to conventional laparoscopic surgery (CLS). Data are lacking about the effect of SLS on POD. This retrospective study evaluated the clinical benefits of SLS for POD in elderly patients with colon cancer. METHODS: This retrospective case-control study included colon cancerpatients (n = 134) over 75 years old who underwent elective surgery from 2009 to 2015 at Osaka University Hospital. Of these patients, 110 were evaluated using the comprehensive geriatric assessment (CGA) before surgery and were classified into lower or higher risk groups based on their scores. RESULTS: The rate of POD was significantly lower in the SLS group than the CLS group (13.8% vs. 30.0%; p = 0.0161). In the CGA-based higher risk group, the rate of POD was significantly higher in the CLS group than the SLS group (p = 0.0153). CONCLUSIONS:SLS for elderly colon cancerpatients may lower the incidence of POD compared with CLS.
Authors: Martin G Kat; Jos F de Jonghe; Ralph Vreeswijk; Tjeerd van der Ploeg; Willem A van Gool; Piet Eikelenboom; Kees J Kalisvaart Journal: Age Ageing Date: 2011-03-17 Impact factor: 10.668