Laparoscopic resection of colorectal cancer: matched comparison in elderly and younger patients

Fiscon, Valentino; Portale, Giuseppe; Frigo, Flavio; Migliorini, Giovanni

doi:10.1007/s10151-010-0635-7

Cited by 20 publications

(15 citation statements)

References 17 publications

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“…There were many reports of the advantages of laparoscopic colorectal surgery in elderly patients, and studies show that it can be safely performed in very old patients with colorectal cancer [910111213]. …”

Section: Introductionmentioning

confidence: 99%

Laparoscopic surgery for colorectal cancer in patients over 80 years of age: the morbidity outcomes

Lim

Kim

2017

Ann Surg Treat Res

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PurposeThe aim of this study was to compare the outcomes between patients under 60 years of age and older patients over 80 years of age who underwent laparoscopic colorectal surgery with colorectal cancer.MethodsA retrospective analysis of 519 colorectal patients who underwent laparoscopic colorectal surgery for colorectal adenocarcinoma between January 2007 and December 2012 was collected and categorized into 2 groups of patients, those under 60 years of age (n = 404) and those over 80 years of age (n = 115).ResultsThe group of patients over 80 years of age had a significantly higher ASA physical status classification (P < 0.001), more preoperative comorbidities (P < 0.001), had a tendency towards more tumors in a colonic location (P = 0.034), and more advanced American Joint Committee on Cancer TNM stage (P = 0.001). A higher proportion of right hemicolectomy and abdominoperineal resection was performed and more transfusions were required in the group of patients over 80 years of age (P = 0.002 and P = 0.001, respectively). There were no significant differences in operative time, conversion rate, resection margins, and numbers of harvested lymph nodes, hospital stay, and morbidity between the 2 groups. No postoperative mortality was found in the present study. The 3-year DFS for over 80 years age group and under 60 years age group were 73.5% and 73.9%, respectively (P = 0.770).ConclusionLaparoscopic colorectal surgery was effective and safe for elderly patients over 80 years of age and resulted in postoperative outcomes similar to those in younger patients. The postoperative morbidity after laparoscopic colorectal cancer surgery was not increased in over 80 years of age.

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Section: Introductionmentioning

confidence: 99%

Laparoscopic surgery for colorectal cancer in patients over 80 years of age: the morbidity outcomes

Lim

Kim

2017

Ann Surg Treat Res

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“…In contrast, complications, particularly those related to advanced age, and 30-day mortality have paramount significance. Although the results of recent studies evaluating whether or not postoperative morbidity and mortality are increasing with advancing age have been controversial, a multicenter analysis of 8,077 colorectal cancer patients operated on with conventional or laparoscopic techniques has shown that age is a significant risk factor for early postoperative mortality [1,12,17,23,24]. The results of the present study suggest that laparoscopic surgery in the elderly is as safe as in younger patients with regard to postoperative complications and early mortality.…”

Section: Discussionmentioning

confidence: 56%

“…Although laparoscopy has been shown to be effective and safe in patients with colorectal cancer, it remains unclear whether or not this technique has any advantages in elderly patients [7,14,15,17,[20][21][22]. Several studies have been conducted in order to assess the feasibility of laparoscopic colorectal surgery in the elderly both for cancer and for benign disease, and reported the results of comparisons with either younger patients who underwent laparoscopic surgery or elderly patients who underwent conventional operations [12,14,16,18].…”

Section: Discussionmentioning

confidence: 99%

“…Age is a significant risk factor for colorectal cancer; thus, surgeons are gradually and more commonly facing age-related perioperative difficulties while treating these patients. Prospective randomized trials and a meta-analysis have revealed that laparoscopic surgery for sigmoid colon and rectal cancers are feasible and oncologically safe, and the outcomes of laparoscopic colorectal operations for benign and malignant diseases in elderly patients have been analyzed in several studies [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]. Although these reports have generally suggested that advanced age is not a contraindication for laparoscopic surgery, there are several limitations to these analyses; since when reporting results, they have combined benign and malignant disease or tumors located in right/left colon and the rectum.…”

Section: Introductionmentioning

confidence: 99%

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Laparoscopy for sigmoid colon and rectal cancers in septuagenarians: a retrospective, comparative study

et al. 2012

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“…This result suggests that laparoscopic colorectal surgery in older patients is safe and feasible. Fiscon et al 12 compared postoperative outcomes between matched two groups of people ≥75 years (n=50) and 75 (n=50). The study showed more postoperative complications in older patients, even when matched by ASA score and type of operation.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Surgery for Rectal Cancer after Preoperative Chemoradiation in Elderly Patients

Choi

Lee

et al. 2017

J Minim Invasive Surg

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Purpose: Laparoscopic surgery has been accepted as a standard procedure for colorectal cancer.Preoperative chemoradiation for rectal cancer has some advantages, such as decreased tumor size and lower stage, and lower local recurrence. However, preoperative chemoradiation has the disadvantage of increasing postoperative complication risks. The aim of this study was to evaluate the safety of laparoscopic surgery for rectal cancer after preoperative chemoradiation in elderly patients.Methods: 46 patients underwent laparoscopic surgery for rectal cancer after preoperative chemoradiation. Patients were divided into younger (<70 years, n=35) and older groups (≥70 years, n=11). Results:In the younger group, men were more predominant (80% vs. 54.5%, p=0.124). In the older group, more patients had high American Society of Anesthesiologists scores (score 3 was 2.9% vs. 36.4%, p=0.005) than in the younger group. Sphincter-preserving surgery was performed more frequently in the younger group (77.2% vs. 45.5%, p=0.065). Operation time (195.8 min. vs. 212.5 min, p=0.553) and intraoperative blood loss (200.6 cc vs. 209.1 cc, p=0.952) were not significantly different. Significant anastomotic leakage was absent in both groups. Postoperative hospital stay was 9.7 and 10.9 days (p=0.669). Complete remission rates were similar in the both groups (8.8% vs. 18.2%, p=0.824). Conclusion:Postoperative outcomes are comparable between older group and younger group.Laparoscopic surgery could be considered as safe, feasible therapeutic options in elderly patients after preoperative chemoradiation for rectal cancer. However, large randomized trials with comparative methodologies are needed.

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Laparoscopic resection of colorectal cancer: matched comparison in elderly and younger patients

Cited by 20 publications

References 17 publications

Laparoscopic surgery for colorectal cancer in patients over 80 years of age: the morbidity outcomes

Laparoscopic surgery for colorectal cancer in patients over 80 years of age: the morbidity outcomes

Laparoscopy for sigmoid colon and rectal cancers in septuagenarians: a retrospective, comparative study

Laparoscopic Surgery for Rectal Cancer after Preoperative Chemoradiation in Elderly Patients

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