Colorectal resection in nonagenarians: Effectiveness of laparoscopic surgery

Soma, Toshiya; Sugano, Motoki; Kawasaki, Chihiro; Tsuji, Masae; Fukui, Izumi

doi:10.1111/ases.12105

Cited by 10 publications

(8 citation statements)

References 23 publications

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“…Only five series have been reported in which nonagenarians with CRC have been exclusively included and most of them with a small number of patients [8][9][10][11][12]. Some other studies have differentiated the characteristics of nonagenarians but in the context of large series that mainly include octogenarians [2,13,14].…”

Section: Introductionmentioning

confidence: 99%

Colorectal cancer surgery in selected nonagenarians is relatively safe and it is associated with a good long-term survival: an observational study

et al. 2020

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Background: Advanced age is a risk factor for colorectal cancer, and very elderly patients often need to be surgically treated. This study aimed to analyze the outcomes of a cohort of nonagenarian patients operated on for colorectal cancer. Methods: Observational study conducted on a cohort of 40 nonagenarian patients, who were treated surgically for colorectal cancer between 2000 and 2018 in our institution. Clinical data, ASA score, Charlson Comorbidity Index, Surgical Mortality Probability Model, tumor characteristics, and nature and technical features of the surgical procedure, were recorded. The Comprehensive Complication Index (CCI) and survival time after the procedure were recorded as outcome variables. Univariate and multivariate analyses were performed in order to define risk factors for postoperative complications and long-term survival. Results: Out of the 40 patients, 13 (32.5%) were men, 27 (67.5%) women, and mean age 91.6 years (SD ± 1.5). In 24 patients (60%), surgery was elective, and in 16 patients (40%), surgery was emergent. Curative surgery with intestinal resection was performed in 34 patients (85%). In 22 patients (55%), intestinal continuity was restored by performing an anastomosis. The median CCI was 22.6 (IRQ 0.0-42.6). Operative mortality was 10% (4 patients). Cumulative survival at 1, 3, and 5 years was 70%, 47%, and 29%, respectively. In multivariate analysis, only the need for transfusion remained as an independent prognostic factor for complications (p = 0.021) and TNM tumor stage as a significant predictor of survival (HR 3.0, CI95% 1.3-7.2). Conclusions: Colorectal cancer surgery is relatively safe in selected nonagenarian patients and may achieve longterm survival.

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Section: Introductionmentioning

confidence: 99%

Colorectal cancer surgery in selected nonagenarians is relatively safe and it is associated with a good long-term survival: an observational study

et al. 2020

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“…Given the potential for cure with surgery, however, patients and their families often choose surgery over conservative, but less curative, treatment, particularly in the emergency setting. While surgical resection for colorectal cancer offers the best chance of survival in most age groups, 30‐day mortality and long‐term survival data in patients ≥ 90 years of age is limited to a handful of small studies .…”

Section: Introductionmentioning

confidence: 99%

Colorectal cancer resection in the Australian nonagenarian patient

et al. 2017

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“…There have been many reports regarding laparoscopic surgery for colorectal cancer in very elderly patients . They have demonstrated that laparoscopic colectomy is a feasible and safe option.…”

Section: Discussionmentioning

confidence: 99%

Successful laparoscopic treatment of advanced rectal cancer in an extremely elderly man (101 years and 9 months)

Nagai¹,

Togo²,

Nakagi³

et al. 2017

Asian J Endoscop Surgery

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An extremely elderly man (age, 101 years and 9 months) visited our hospital because of recurrent and worsening anal bleeding. Type 2 rectal cancer was found in his rectum during colonoscopy. He did not have any severe coexisting diseases and had not suffered any episodes of dementia. Laparoscopy-assisted anterior resection combined with D2 lymph node dissection was performed with minimal bleeding. The operation time was 128 min. The patient suffered mild reflux pneumonia on postoperative day 6 and was administered additional antibiotics. He recovered within 2 days. He was discharged on postoperative day 17, at which point he was able to walk.

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Colorectal resection in nonagenarians: Effectiveness of laparoscopic surgery

Abstract: Laparoscopic surgery is considered an extremely useful treatment for very old patients because it has a low risk of postoperative complications, even in the presence of pre-existing diseases. We conclude that LAC may be indicated in nonagenarians.

Cited by 10 publications

References 23 publications

Colorectal cancer surgery in selected nonagenarians is relatively safe and it is associated with a good long-term survival: an observational study

Colorectal cancer surgery in selected nonagenarians is relatively safe and it is associated with a good long-term survival: an observational study

Colorectal cancer resection in the Australian nonagenarian patient

Successful laparoscopic treatment of advanced rectal cancer in an extremely elderly man (101 years and 9 months)

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