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

Abstract

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.

Nomogram for Prediction of Postoperative Morbidity in Patients with Colon Cancer Requiring Emergency Therapy

“…In the present study, the duration of surgery of less than 2.5 h was associated with the absence of postoperative complications. The duration of surgery was an independent predictor of complications, which is in accordance with the data reported in the literature [ 21 , 32 ].…”

“…The independent factors found to predict the occurrence of postoperative complications in the study group were age >68 years, ECOG performance status of 4, Charlson score >3, presence of cachexia, pathologic value of WBC and creatinine, coagulation, electrolyte disorders, duration of surgery, and use of antibiotic regimen (carbapenems). Other authors also reported advanced age as a risk factor for postoperative complications [ 21 , 22 ].…”

Safety of anastomotic techniques and consequences of anastomotic leakage in patients with colorectal cancer: a single surgeon experience

“…Due to a larger amount of right colon tumors, mostly entero-colonic anastomoses were performed, which entailed a high percentage of anastomotic leaks, as reported by other authors as well [ 5 ]. Furthermore, Akiyoshi et al [ 6 ] highlighted that anastomosis performed on the proximal parts of the large bowel presented lower chances of AL.…”

Enhancing recovery in older patients undergoing abdominal surgery: Examining the effect of a preoperative preparation program using a quasi-experimental design

“…Major abdominal surgery in older adult patients carries a significant risk due to the body’s deterioration and preexisting comorbidities (Etele et al, 2019 ). The impact of anesthesia during abdominal surgery can have long-lasting effects, while blood loss can affect the muscular, respiratory, and circulatory systems, leading to anemia, fatigue, and delirium (Bettelli & Neuner, 2017 ).…”

“…Existing research has consistently shown that older adult patients are more susceptible to postoperative complications than other patient groups (Chinuntuya & Chutitorn, 2016 ; Dajenah et al, 2022 ). These complications encompass infections, confusion, ileus, and gastroparesis (Dajenah et al, 2022 ), which can result in an extended duration of hospitalization for patients (Etele et al, 2019 ).…”