Laparoscopic Colorectal Resection: A Safe Option for Elderly Patients

Law, Wai Lun; Chu, Kin Wah; Tung, Peter H. M.

doi:10.1016/s1072-7515(02)01483-7

Cited by 165 publications

(128 citation statements)

References 20 publications

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“…This is more a theoretical assumption cited by some authors [19], but in the literature there are no such case reports of barotrauma due to inadvertent ventilation during laparoscopy. Although there is an important impairment of pulmonary function and gas exchange during laparoscopy, the recovery of pulmonary function is more rapid and the rate of pulmonary sequelae (atelectasis) or complications (pneumonia) is lower than after open surgical procedures, irrespective to the magnitude of the procedures or age of the patient [42, 43, 44, 45]. …”

Section: Lungs and Gas Exchangementioning

confidence: 99%

Circulatory and Respiratory Complications of Carbon Dioxide Insufflation

Gutt¹,

Oniu

Mehrabi³

et al. 2004

Dig Surg

291

272

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Background: Although providing excellent outcome results, laparoscopy also induces particular pathophysiological changes in response to pneumoperitoneum. Knowledge of the pathophysiology of a CO₂ pneumoperitoneum can help minimize complications while profiting from the benefits of laparoscopic surgery without concerns about its safety. Methods: A review of articles on the pathophysiological changes and complications of carbon dioxide pneumoperitoneum as well as prevention and treatment of these complications was performed using the Medline database. Results: The main pathophysiological changes during CO₂ pneumoperitoneum refer to the cardiovascular system and are mainly correlated with the amount of intra-abdominal pressure in combination with the patient’s position on the operating table. These changes are well tolerated even in older and more debilitated patients, and except for a slight increase in the incidence of cardiac arrhythmias, no other significant cardiovascular complications occur. Although there are important pulmonary pathophysiological changes, hypercarbia, hypoxemia and barotraumas, they would develop rarely since effective ventilation monitoring and techniques are applied. The alteration in splanchnic perfusion is proportional with the increase in intra-abdominal pressure and duration of pneumoperitoneum. Conclusion: A moderate-to-low intra-abdominal pressure (<12 mm Hg) can help limit the extent of the pathophysiological changes since consecutive organ dysfunctions are minimal, transient and do not influence the outcome.

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Section: Lungs and Gas Exchangementioning

confidence: 99%

Circulatory and Respiratory Complications of Carbon Dioxide Insufflation

Gutt¹,

Oniu

Mehrabi³

et al. 2004

Dig Surg

291

272

View full text Add to dashboard Cite

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“…The number of colon cancers requiring surgical intervention continues to increase due to the prolongation of life expectancy in many nations (2). Recently, multi-port laparoscopic surgery (MLS) has been adopted more frequently worldwide for the treatment of colon cancer.…”

Section: Introductionmentioning

confidence: 99%

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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“…Several retrospective studies have shown the benefits of laparoscopic surgery for elderly patients with colorectal cancer in terms of postoperative outcomes, including reduction of pain, earlier intestinal peristaltic recovery, shortening of postoperative stay, and cosmetic advantage [8][9][10][11][12][13][14]. The diffusion of laparoscopic surgery for colorectal cancer was 46.8 % in 2011 according to the 11th Nationwide Survey of Endoscopic Surgery in Japan [15].…”

Section: Introductionmentioning

confidence: 99%