Masatoshi Kochi1, Takao Hinoi2,3, Hiroaki Niitsu1, Hideki Ohdan1, Fumio Konishi4,5, Yusuke Kinugasa6,7, Takaya Kobatake8, Masaaki Ito9, Masafumi Inomata10, Toshimasa Yatsuoka11,12, Takashi Ueki13,14, Jo Tashiro15, Shigeki Yamaguchi15, Masahiko Watanabe16. 1. Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minamiku, Hiroshima, 734-8551, Japan. 2. Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minamiku, Hiroshima, 734-8551, Japan. thinoi@hiroshima-u.ac.jp. 3. Department of Surgery, Institute for Clinical Research, National Hospital Organization Kure Medical Center and Chu-goku Cancer Center, 3-1, Aoyama-cho, Kure-shi, Hiroshima, 737-0023, Japan. thinoi@hiroshima-u.ac.jp. 4. Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Ohmiya-ku, Saitama, 330-8503, Japan. 5. Department of Surgery, Nerima Hikarigaoka Hospital, 2-11-1 Hikarigaoka, Nerima, Tokyo, 179-0072, Japan. 6. Division of Colon and Rectal Surgery, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan. 7. Department of Gastroenterological Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan. 8. Department of Surgery, Division of Gastroenterological Surgery, National Hospital Organization Shikoku Cancer Center, 160 Koh, Umemotomachi, Matsuyama, Ehime, 791-0280, Japan. 9. Division of Surgical Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan. 10. Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hazama-cho, Yufu, Oita, 879-5593, Japan. 11. Department of Gastroenterological Surgery, Saitama Cancer Center, 780 Komuro, Inamachi, Kita-Adachi-gun, Saitama, 362-0806, Japan. 12. Department of Gastroenterological and General Surgery, Showa University Fujigaoka Hospital, 1-30 Fujigaoka, Aoba-ku, Yokohama, Kanagawa, 227-8501, Japan. 13. Department of Surgery and Oncology, Kyushu University Graduate School of Medical Sciences, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. 14. Department of Gastroenterological Surgery, Hamanomachi Hospital, 3-3-1 Nagahama, Chuo-ku, Fukuoka, 810-8539, Japan. 15. Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan. 16. Department of Surgery, Kitasato University, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0374, Japan.
Abstract
PURPOSE: Postoperative pneumonia affects the length of stay and mortality after surgery in elderly patients with colorectal cancer (CRC). We aimed to determine the risk factors of postoperative pneumonia in elderly patients with CRC, and to evaluate the impact of laparoscopic surgery on elderly patients with CRC. METHODS: We retrospectively investigated 1473 patients ≥ 80 years of age who underwent surgery for stage 0-III CRC between 2003 and 2007. Using a multivariate analysis, we determined the risk factors for pneumonia occurrence from each baseline characteristic. RESULTS: Among all included patients, 26 (1.8%) experienced postoperative pneumonia, and restrictive respiratory impairment, obstructive respiratory impairment, history of cerebrovascular events, and open surgery were determined as risk factors (odds ratio [95% confidence interval], 2.78 [1.22-6.20], 2.71 [1.22-6.30], 3.60 [1.37-8.55], and 3.57 [1.22-15.2], respectively). Furthermore, postoperative pneumonia was more frequently accompanied by increasing cumulative numbers of these risk factors (area under the receiver operating characteristic curve = 0.763). CONCLUSIONS: Laparoscopic surgery may be safely performed in elderly CRC patients, even those with respiratory impairment and a history of cerebrovascular events.
PURPOSE:Postoperative pneumonia affects the length of stay and mortality after surgery in elderly patients with colorectal cancer (CRC). We aimed to determine the risk factors of postoperative pneumonia in elderly patients with CRC, and to evaluate the impact of laparoscopic surgery on elderly patients with CRC. METHODS: We retrospectively investigated 1473 patients ≥ 80 years of age who underwent surgery for stage 0-III CRC between 2003 and 2007. Using a multivariate analysis, we determined the risk factors for pneumonia occurrence from each baseline characteristic. RESULTS: Among all included patients, 26 (1.8%) experienced postoperative pneumonia, and restrictive respiratory impairment, obstructive respiratory impairment, history of cerebrovascular events, and open surgery were determined as risk factors (odds ratio [95% confidence interval], 2.78 [1.22-6.20], 2.71 [1.22-6.30], 3.60 [1.37-8.55], and 3.57 [1.22-15.2], respectively). Furthermore, postoperative pneumonia was more frequently accompanied by increasing cumulative numbers of these risk factors (area under the receiver operating characteristic curve = 0.763). CONCLUSIONS: Laparoscopic surgery may be safely performed in elderly CRC patients, even those with respiratory impairment and a history of cerebrovascular events.
Entities:
Keywords:
Colon cancer; Elderly patient; Laparoscopic surgery; Pneumonia; Rectal cancer
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