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Jung, Shin, and Suh: The Short-term Outcome and Safety of Laparoscopic Colorectal Cancer Resection in Very Elderly Patients
Original Article
Alimentary Tract

The Korean Journal of Gastroenterology 2017; 69(5): 291-297.

Published online: 25 May 2017

DOI: https://doi.org/10.4166/kjg.2017.69.5.291

The Short-term Outcome and Safety of Laparoscopic Colorectal Cancer Resection in Very Elderly Patients

Won Beom Jung, Jin Yong Shin, Byoung Jo Suh

Department of Surgery, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.

Correspondence to: Jin Yong Shin, Department of Surgery, Inje University Haeundae Paik Hospital, Inje University College of Medicine, 875 Haeun-daero, Haeundae-gu, Busan 48108, Korea. Tel: +82-51-797-0266, Fax: +82-84-797-0261, jyong@paik.ac.kr

Received 14 January 2017       Revised 14 February 2017       Accepted 22 February 2017

Copyright © 2017. Korean Society of Gastroenterology

(open-access):

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background/Aims

Due to the recent increase in elderly population, laparoscopic surgery is more frequently performed in the elderly. This study aimed to compare the short-term outcomes of laparoscopic colorectal cancer surgery between the very elderly group (VEG), categorized as those with age over 80 years and the elderly group (EG), categorized as those with age 65 to 79 years.

Methods

We retrospectively compared 48 very elderly patients with 96 elderly patients (1:2 matched) who underwent laparoscopic resection for colorectal cancers at our institution between March 2010 and December 2014. The clinicopathologic parameters, surgical characteristics and short term outcomes were compared.

Results

There was no statistically significant difference in clinicopathologic characteristics between VEG and EG. Postoperative pain score (7 points vs. 6 points, p=0.264), time to first flatus (3 days vs. 3 days, p=0.335), hospital stay (15 days vs. 16.5 days, p=0.361), complication rates (47.9% vs. 26.0%, p=0.147) and major complication rate (25% vs. 20.8%, p=0.681) were not statistically different between the two groups. Before surgery, VEG had higher rate of neurologic underlying disease, such as dementia or cerebrovascular disease, than EG (25.0% vs. 7.3%, p=0.007).

Conclusions

There was no significant difference in the clinicopathologic characteristics, short-term outcomes, and complication rates for laparoscopic colorectal resection between VEG and EG, except delirium. Age over 80 years may be relevant for the application of laparoscopic colorectal cancer resection.

Keywords: Laparoscopic surgery, Colorectal cancer, Mordidity, Elderly

Figures and Tables

Fig. 1

Overall study design and overview of patient population. CRC, colorectal cancer.

kjg-69-291-g001
Table 1

Clinicopathologic Characteristics of Elderly Patients Who Underwent Laparoscopic Colectomy for Colorectal Cancer

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Values are presented as mean (range) or n (%) unless otherwise indicated.

VEG, very elderly group ≥80 years; EG, elderly group ≥65 years and <80 years; CEA, carcinoembryonic antigen; ASA, American society of anesthesiologists; BMI, body mass index; NSSO, non sphincter saving operation including abdominoperineal resection and Hartmann's operation.

Table 2

Pathologic Results of Elderly Patients Who Underwent Laparoscopic Resection for Colorectal Cancer

kjg-69-291-i002

Values are presented as mean±standard error (range) or n (%) unless otherwise indicated.

VEG, very elderly patients group; EG, elderly patients group; LN, lymph node; EBL, estimated blood loss; PRM, proximal resection margin; DRM, distal resection margin.

Table 3

Short-term Outcome Measures Following Laparoscopic Colorectal Cancer Resection

kjg-69-291-i003

Values are presented as median (range) or n (%) unless otherwise indicated.

VEG, very elderly patients group; EG, elderly patients group.

aMaximum visual analogous scores on day 1 to 7 after surgery were used to assess postoperative pain severity.

Table 4

Types of Complication after Surgery

kjg-69-291-i004

Numbers in parenthesis were percentages.

VEG, very elderly patients group; EG, elderly patients group; EPSBO, early postoperative small bowel obstruction.

aMajor complications were defined as Clavien – Dindo grade III or IV.

Notes

Financial support None.

Conflict of interest None.

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