Postoperative complications in individuals aged 70 and over undergoing elective surgery for colorectal cancer

Fagard, Katleen; Casaer, Julie; Wolthuis, Albert; Flamaing, Johan; Milisen, Koen; Lobelle, Jean-Pierre; Wildiers, Hans; Kenis, Cindy

doi:10.1111/codi.13821

Cited by 44 publications

(30 citation statements)

References 59 publications

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“…[21][22][23][24] In fact, our results also confirm prior findings on the increased LOS in >60-years-old after donor nephrectomy. [21][22][23][24] In fact, our results also confirm prior findings on the increased LOS in >60-years-old after donor nephrectomy.…”

Section: Discussionsupporting

confidence: 91%

“…Furthermore, our findings that >60-years-old exhibited a higher incidence of postoperative ileus after surgery and had longer LOS are not novel, as multiple groups have observed this in large cohorts of geriatric patients undergoing emergent and elective surgery. [21][22][23][24] In fact, our results also confirm prior findings on the increased LOS in >60-years-old after donor nephrectomy. 14 Thus, our findings demonstrate that perioperative morbidity and short-term outcomes are a minimal acceptable concession for the benefits of a living donor kidney to the respective recipient.…”

Section: Discussionsupporting

confidence: 91%

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Age alone is not a contraindication to kidney donation: Outcomes of donor nephrectomy in the elderly

Serrano

Yadav

Bangdiwala

et al. 2018

Clinical Transplantation

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With increasing organ demand, living kidney donation from older donors (>60-years-old) has become more common. Between 1975 and 2014, 3752 donor nephrectomies (DN) were performed at University of Minnesota; 167 (4.5%) were >60-years-old Short- and long-term outcomes were compared between contemporaneous >60-years-old and <60-years-old donors. On univariate analysis, >60-years-old were more likely to have had prior abdominal surgery and hypertension; and less likely to smoke. Baseline estimated glomerular filtration rate (eGFR) was lower in >60-years-old (80 ± 16 vs 101 ± 26 mL/min/1.73 m ; P < .001). Intraoperative and postoperative complications were similar, except a higher prevalence of <30 day ileus (3% vs 7%; P = .021) and longer postoperative length of stay (LOS) (4.2 vs 4.6 days; P = .005). On multivariate analysis, <30 day ileus and LOS continued to be significantly greater for >60-years-old After >20 years post-DN, systolic blood pressure was significantly higher among >60-years-old (142 vs 125 mm Hg; P < .001) and HTN was diagnosed earlier (9 vs 14 years). After donation, eGFR was significantly lower for >60-years-old but slope of eGFR and rates of end-stage renal disease (ESRD) were not significantly different >20 years post-DN. Thus, kidney donation among carefully selected >60-years-old poses minimal perioperative risks and no added risk of long-term ESRD.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 91%

Age alone is not a contraindication to kidney donation: Outcomes of donor nephrectomy in the elderly

Serrano

Yadav

Bangdiwala

et al. 2018

Clinical Transplantation

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“…In the current study, the number of surgical complications after laparoscopic treatment was 10.7%. Similar results are presented a Belgian prospective study evaluating treatment outcomes in 2009-2015 in patients who reported 17.9% complications [8], and by British researchers -12.4% [9]. In the group of older patients (>65-years-old) the number of complications was greater, which is confirmed by Cummings et al, who reported the proportion of complications at 21.5% and early mortality at 3.3% [10].…”

Section: Discussionsupporting

confidence: 81%

“…In the group of patients who underwent surgery in Kielce, surgical site infection after laparoscopy was reported in seven patients, representing 0.5% of the group. The results presented by other authors range from 0% (Cummings et al [10]) to 12.1% (Fagard et al [8]).…”

Section: Discussionmentioning

confidence: 84%

Laparoscopic treatment of patients with colorectal cancer – Technique assessment at an oncological centre

Ciepiela¹,

Macek²,

Haduch³

et al. 2019

Med Og Nauk Zdr.

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Introduction and objective. Colorectal cancer is the third most common cancer in males and the second in females in the Świętokrzyskie region of southeast Poland. In 2015, 354 new colorectal cancer cases in males and 290 in females were reported. Minimally invasive procedures with a modern approach to preoperative care have become a new challenge for the surgeon and a link to robotic surgery. The aim of the study is to analysis surgical complications in the first years from the introduction of laparoscopic procedures for colorectal cancer surgery. Materials and method. Laparoscopic colon resection started at the Department of Surgical Oncology of the Świętokrzyskie Cancer Centre in 2011. The method was applied in the treatment of 196 patients mainly with malignant tumour of the colon and the rectum. In 30.6% of patients, open conversion to the procedure was performed. Complications and long-term results were analysed, assessing the operating time, length of hospital stay, local complications as well as early and late mortality. Results. The duration of laparoscopic procedures was longer compared to the treatment through laparotomy. The median of hospital stay was seven days. The following complications were observed: infection of the surgical wound in 4.1% patients, bleeding or wound dehiscence and hernia anastomosis in 2.4% patients. The conversion was performed in 58 patients, most often because of adhesions (42%) or extensive infiltration of tumour (39%). Early postoperative mortality of up to 30 days after the surgery was observed in 0.5% patient, while within a year after surgery-in 8.2% of patients. Conclusions. In the course of laparoscopic colon resection, no increase was observed in the number of perioperative complications. A large percentage of conversion demonstrates the need for further training of the operating team.

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“…As a summary, the overall complication rate was 42.02 %, while mortality represented 7.97 %and was statistically significant in favor of patients who presented post-operative complications. Aspects stated before can be found in multiple studies (28)(29)(30)(31)(32)(33).…”

Section: Resultsmentioning

confidence: 94%

Elderly Patients with Colorectal Cancer - A Predisposed Category for Postoperative Complications

Etele¹,

Sala²,

Dénes³

et al. 2019

chr

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Introducere: Cancerul colorectal (CRC) se numără printre principalele cauze de deces cauzate de cancer în întreaga lume. Pacienţii vârstnici sunt adesea consideraţi ca fiind o categorie cu risc crescut, predispuşi la complicaţii postoperatorii. Materiale şi metode: 138 pacienţi cu vârsta de peste 75 de ani şi diagnosticaţi cu cancer colorectal au fost revizuiţi retrospectiv. Pacienţii au fost împărţiţi în două grupuri: Grupul de studiupacienţii care au dezvoltat complicaţii postoperatorii, şi Grupul de control-pacienţii fără probleme în perioada postoperatorie. Au fost comparate date clinice, preoperatorii, chirurgicale, postoperatorii şi oncologice. Scopul studiului a fost de a determina posibili factori de risc în apariţia complicaţiilor postoperatorii şi de a analiza influenţa acestora asupra mortalităţii. Rezultate: Factori de risc cum ar fi sexul bărbătesc, obezitate, insuficienţa cardiacă, diabet zaharat tip II, anemie severă, hipoproteinemie, clasificare ASA III-IV, intervenţiile chirurgicale efectuate în urgenţă, timp operator îndelungat, sângerări semnificative intra-operatorie, internare prelungită, localizare distală a formaţiunilor tumorale, stadiile TNM III-IV, antecedente de cancer digestiv operat sau alte operaţii abdominale majore necanceroase efectuate au fost identificaţi. Concluzii: Tratamentul chirurgical al cancerului colorectal în cazul populaţiei cu vârstă înaintată rămâne o provocare, această categorie de pacienţi trebuie să beneficieze de o atenţie deosebită pentru a asigura o şansă de a minimaliza sau evita aceste complicaţii.

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Postoperative complications in individuals aged 70 and over undergoing elective surgery for colorectal cancer

Abstract: This study shows that in-hospital medical and surgical complications after surgery for colorectal cancer in patients ≥ 70 years old are frequent and that complications lead to less favourable outcomes.

Cited by 44 publications

References 59 publications

Age alone is not a contraindication to kidney donation: Outcomes of donor nephrectomy in the elderly

Age alone is not a contraindication to kidney donation: Outcomes of donor nephrectomy in the elderly

Laparoscopic treatment of patients with colorectal cancer – Technique assessment at an oncological centre

Elderly Patients with Colorectal Cancer - A Predisposed Category for Postoperative Complications

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