Laparoscopic colectomy is safe and leads to a significantly shorter hospital stay for octogenarians

Lian, Lei; Kalady, Matthew F.; Geisler, Daniel; Kiran, Ravi P.

doi:10.1007/s00464-010-0900-x

Cited by 55 publications

(33 citation statements)

References 23 publications

(29 reference statements)

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“…In our study, 7.8% of patients suffered cardio-respiratory complications. This is comparable to rates of 6.7% to 14.4% quoted in the literature [6,11,13,28]. Of note, incidence of cardio-respiratory complications was similar in both LC and OC groups but mortality rate from these complications was higher in the OC group.…”

Section: Discussionsupporting

confidence: 90%

“…Perioperative outcomes in laparoscopic surgery for the elderly remain non-conclusive. In laparoscopic colectomies, postoperative outcomes were noted to be similar in both elderly and younger patients in some studies [6][7][8], while others, however, have shown superior outcomes in the LC group [9][10][11][12][13][14][15]. Studies examining laparoscopic surgery in both young and elderly patients have found that the benefits of laparoscopic surgery are more marked in elderly patients [16,17].…”

Section: Introductionmentioning

confidence: 91%

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Evaluation of laparoscopic versus open colorectal surgery in elderly patients more than 70 years old: an evaluation of 727 patients

Tan

Chew

Lim

et al. 2011

Int J Colorectal Dis

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 91%

Evaluation of laparoscopic versus open colorectal surgery in elderly patients more than 70 years old: an evaluation of 727 patients

Tan

Chew

Lim

et al. 2011

Int J Colorectal Dis

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“…Following analysis, LC was found to be associated with a significantly lower estimated blood loss and intraoperative transfusion rate, although the operative time was longer when compared to laparotomy. These results are similar to those reported by previous studies, as the operative time of the laparoscopic procedure was reported to be 20-30 min longer compared to laparotomy (9)(10)(11)(12). Only in the study by Senagore et al was the operative time reported to be shorter with LC (14), but no further discussion was offered regarding this finding.…”

Section: Discussionsupporting

confidence: 73%

“…The decreased hospital stay reflects the faster postoperative recovery of oral intake of food, bowel function and physical activity (9,10,(15)(16)(17)(18), athough such variables were not analyzed in our study.…”

Section: Discussionmentioning

confidence: 99%

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Short-term outcomes between laparoscopy-assisted and open colorectomy for colorectal cancer in elderly patients: A case-matched control study

Jing

Zeng

et al. 2015

Molecular and Clinical Oncology

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Abstract. With the increase in life expectancy, surgical intervention for colorectal cancer (CRC) is more frequently performed in elderly patients. This retrospective study was designed to compare short-term outcomes between laparoscopy-assisted colorectomy (LC) and open colorectomy (OC) in elderly patients with CRC. A total of 89 CRC patients aged ≥75 years undergoing LC were matched with 89 counterparts undergoing OC. The matching criteria included general information and preoperative status. The operative data and short-term postoperative outcomes were compared. Following analysis, patients in the LC and OC groups were comparable for the matching criteria. Compared with the OC group, the operative time was longer (P=0.046), but the estimated blood loss (P<0.001) and intraoperative transfusion (P=0.042) were less in the LC group. As regards short-term postoperative outcomes, the duration of postoperative hospital stay was shorter (P=0.001) and the incidence of wound complications was lower (P=0.044) with LC. The overall complication, other complications, reoperation and mortality rates were comparable between the two groups. In conclusion, considering the operative variables and short-term outcomes, LC is a safe procedure and appears to be superior to OC for elderly patients with CRC. IntroductionDue to the significant advances in life quality and health care, life expectancy continues to increase worldwide, with a consequent increase in the elderly population. The incidence of colorectal diseases necessitating surgical intervention, particularly colorectal cancer (CRC), usually increases with advancing age. In fact, approximately one half of patients with CRC are aged >70 years and CRC is the second leading cause of cancer-related mortality in this age group (1,2). Aging per se, regardless of other factors, is not a prognostic factor in gastrointestinal surgery (3). However, advanced age is usually accompanied by underlying comorbidities, such as cardiovascular and pulmonary diseases, which may significantly affect the outcomes of surgical treatment for CRC. Thus, surgery for elderly CRC patients is a major medical care issue.Surgeons usually select colorectomy for CRC treatment in resectable cases, which may be performed as open colorectomy (OC) or laparoscopy-assisted colorectomy (LC). The laparoscopic procedure, compared with laparotomy, is considered to be a safe and feasible procedure, associated with a milder immunological and inflammatory response (4). Furthermore, LC is reportedly associated with decreased morbidity and mortality, faster recovery and shorter hospital stay (5,6). However, LC usually requires longer operative time and results in specific physiological changes affecting the cardiovascular and pulmonary systems (7). Due to these concerns and underlying comorbidities in elderly patients, surgeons face a dilemma when considering LC for CRC.The availability of recent reports comparing LC and OC for elderly patients is limited (8-12), with data on CRC being even more scarse (12). To the best...

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Reduced Risk of Medical Morbidity and Mortality in Patients Selected for Laparoscopic Colorectal Resection in England

Mamidanna¹

2012

Arch Surg

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Laparoscopic colectomy is safe and leads to a significantly shorter hospital stay for octogenarians

Abstract: Complications and other outcomes are similar for LC and OC, and the earlier recovery associated with LC, as evidenced by a shorter hospital stay, may encourage a wider adoption of LC for patients older than 80 years.

Cited by 55 publications

References 23 publications

Evaluation of laparoscopic versus open colorectal surgery in elderly patients more than 70 years old: an evaluation of 727 patients

Evaluation of laparoscopic versus open colorectal surgery in elderly patients more than 70 years old: an evaluation of 727 patients

Short-term outcomes between laparoscopy-assisted and open colorectomy for colorectal cancer in elderly patients: A case-matched control study

Reduced Risk of Medical Morbidity and Mortality in Patients Selected for Laparoscopic Colorectal Resection in England

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