Laparoscopic Versus Open Surgery for Colorectal Cancer in Elderly Patients: A Multicenter Matched Case–Control Study

Hinoi, Takao; Kawaguchi, Yasuo; Hattori, Minoru; Okajima, Masazumi; Ohdan, Hideki; Yamamoto, Seiichiro; Hasegawa, Hirotoshi; Horie, Hisanaga; Murata, Kohei; Yamaguchi, Shigeki; Sugihara, Kenichi; Watanabe, Masahiko

doi:10.1245/s10434-014-4172-x

Cited by 99 publications

(74 citation statements)

References 28 publications

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“…The proportion of elderly patients requiring major abdominal surgery is increasing (24,30). It is clear that, as patients age, there is an associated increase in comorbid conditions that often complicate the perioperative management of elderly patients who undergo major surgery (24,30).…”

Section: Discussionmentioning

confidence: 99%

“…It is clear that, as patients age, there is an associated increase in comorbid conditions that often complicate the perioperative management of elderly patients who undergo major surgery (24,30). MLS is currently considered to be safe and feasible in elderly patients, and evidence has suggested that it is not inferior to the open procedure, as it seems to be less physiologically stressful than conventional open laparotomy (24,30). SLS offers a potential advantage in the context of minimally invasive surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have reported that MLS demonstrates oncological results and surgical outcomes comparable to that of open surgery (16)(17)(18)(19)(20)(21)(22)(23). However, in the elderly, although MLS is reported to be non-inferior to the open procedure and may be an acceptable alternative in elderly patients with colorectal cancer (24), no study has investigated the feasibility of SLS in elderly patients with colon cancer, with the exception of one small study (10). Therefore, the critical issue of whether SLS can benefit colon cancer patients of advanced age as an alternative to MLS remains to be elucidated.…”

Section: Introductionmentioning

confidence: 99%

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Single-port versus multi-port laparoscopic surgery for colon cancer in elderly patients

et al. 2016

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Abstract. The safety of single-incision laparoscopic surgery (SLS) in elderly patients with colorectal cancer has not been established. The aim of the current study was to compare the outcomes of SLS and multi-port laparoscopic surgery (MLS) and to assess the feasibility of SLS in colorectal cancer patients aged ≥70 years. A retrospective case-control study of colon cancer patients undergoing elective surgical intervention between 2011 and 2014 was conducted. A total of 129 patients with colon cancer underwent surgery and were included in the analysis. Data regarding patient demographics, surgical variables, oncological outcomes and short-term outcomes were evaluated for statistical significance to compare MLS (n=79) and SLS (n=50) in colon cancer patients. No significant differences were observed in patient characteristics. No case required re-admission within 30 days post surgery. The mean surgery times were similar for the MLS and SLS groups when cases with left and right hemicolectomies were combined (207.7 and 215.9 min, respectively; P= 0.47). In addition, overall perioperative outcomes, including blood loss, number of lymph nodes harvested, size of the surgical margin and complications, were similar between these groups. Thus, we suggest that SLS can be performed safely in elderly patients with colon cancer.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Single-port versus multi-port laparoscopic surgery for colon cancer in elderly patients

et al. 2016

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“…Unfortunately, the noninferiority of laparoscopic D3 dissection in overall survival was not demonstrated for stage II and III colorectal cancer, because the overall survival of both arms was unexpectedly similar. Furthermore, the safety of laparoscopic surgery in elderly patients and in those with Stage IV disease for whom less invasive surgery is desirable, has been demonstrated retrospectively, and another randomized controlled trial is now underway 8,9) . Therefore, during the two decades since its initial introduction, data unique to Japan have steadily been accumulated and serves as evidence for the validity of laparoscopic surgery as a standard treatment for colon cancer.…”

Section: Colon Cancermentioning

confidence: 99%

The present status and developments of laparoscopic surgery for colorectal cancer

Sato

Watanabe

2017

J Anus Rectum Colon

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Abstract:Laparoscopic surgery for colorectal cancer has been shown to be less invasive than open surgery, while maintaining a similar safety level in many clinical trials. Furthermore, there are no significant differences between laparoscopic surgery and open surgery with respect to the long-term outcomes in colon cancer. Thus, laparoscopic surgery has been accepted as one of the standard treatments for colon cancer. In addition, laparoscopic surgery has also achieved favorable outcomes in the treatments of rectal cancer, with many reports showing long-term outcomes comparable to those of open surgery. Furthermore, the magnification in laparoscopy improves visualization in the pelvic cavity and facilitates precise manipulation, as well as providing an excellent educational opportunity. Laparoscopic surgery may be an ideal approach for the treatment of rectal cancer and colon cancer. Recently, two trials showed that, among patients with advanced rectal cancer, the use of laparoscopic surgery as compared with open surgery confirmed to meet the criterion for non-inferiority for long-term outcomes. In addition, new techniques such as single-port and robotic surgery have been introduced for laparoscopic surgery in recent years.

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“…Unfortunately, the non-inferiority of laparoscopic complete mesocolic excision in overall survival was not demonstrated for stage Ⅱ, Ⅲ colorectal cancer, however, because the overall survival of both arms was relatively identical and better than expected. Furthermore, the safety of LS in elderly patients and those with Stage Ⅳ disease, for whom less invasive surgery is desirable, has been demonstrated retrospectively, and another RCT is now underway [8,9] . Therefore, during the two decades since its initial introduction, data unique to Japan, serving as evidence for the validity of LS as a standard therapy for colon cancer, have steadily been accumulated.…”

Section: Colon Cancermentioning

confidence: 99%

Present laparoscopic surgery for colorectal cancer in Japan

Sato

Watanabe

2016

WJCO

Self Cite

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In many clinical studies, laparoscopic surgery (LS) for colon cancer has been shown to be less invasive than open surgery (OS) while maintaining similar safety. Furthermore, there are no significant differences between LS and OS in long-term outcomes. Thus, LS has been accepted as one of the standard treatments for colon cancer. In the treatments of rectal cancer as well, LS has achieved favorable outcomes, with many reports showing long-term outcomes comparable to those of OS. Furthermore, the magnification in laparoscopy improves visualization in the pelvic cavity and facilitates precise manipulation, as well as providing excellent educational effects. For these reasons, rectal cancer has seemed to be well indicated for LS, as has been colon cancer.

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Laparoscopic Versus Open Surgery for Colorectal Cancer in Elderly Patients: A Multicenter Matched Case–Control Study

Abstract: LAP is an acceptable alternative to OP in elderly patients with colorectal cancer.

Cited by 99 publications

References 28 publications

Single-port versus multi-port laparoscopic surgery for colon cancer in elderly patients

Single-port versus multi-port laparoscopic surgery for colon cancer in elderly patients

The present status and developments of laparoscopic surgery for colorectal cancer

Present laparoscopic surgery for colorectal cancer in Japan

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