Long-term results after elective laparoscopic surgery for colorectal cancer in octogenarians

Abstract

The aim of this study was to investigate the short and long term outcomes after elective laparoscopic surgery for colorectal cancer patients over 80 years of age. Methods: This was a retrospective study of all patients of 80 and above, who underwent elective colorectal resection, between January 2007 and January 2016. Data were analysed from a prospectively collected cancer database and cross checked with patient records. Determinants of survival were analysed using log rank test and Kaplan-Meier curves. Results: We identified 293 patients; 110 underwent laparoscopic surgery (LPS). LPS had significantly better overall survival (p=0.0065), disease free survival (p=0.006). The LPS group also had a shorter length of stay-9 vs. 11 days (p<0.00001), 90 day mortality-5.5 vs. 13.7 per cent (p=0.03) and required fewer blood transfusions 22.7 vs.40.4 per cent (p=0.002), when compared to open surgery (OPS). There was no difference in 30 day mortality 1.8 vs. 4.9 per cent (p=0.22), anastomotic leakage 2.3 vs 6 per cent (p=0.20) or post-operative complication rates 44.5 vs. 50.8 per cent (p=0.30). Conclusions: Laparoscopic surgery for patients in their 80s is characterised by better overall and disease free survival compared to open procedures and is associated with shorter postoperative length of stay, and significantly lower 90 day mortality. Patients operated on laparoscopically also required fewer postoperative blood transfusions.

Laparoscopic Resection of Transverse Colon Cancer with an Anomaly of the Middle Colic Artery Originating from the Splenic Artery: A Case Report

“…Laparoscopic colorectal surgery has been shown to be associated with superior perioperative outcomes to open surgery [ 9 ]. Standardization of surgical procedures and advances in surgical instruments have steadily expanded the indications for laparoscopic colorectal surgery.…”

Rendimiento Y Seguridad De Las Colonoscopías De Screening en Dos Grupos Etáreos De Pacientes De La Tercera Edad

“…Considerando que los casos con hallazgos significativos fueron frecuentes en ambos grupos y que los pacientes octogenarios tuvieron un buen estado clínico y escasas complicaciones, nuestros datos son coherentes con publicaciones que hacen referencia a los buenos resultados que podría tener una eventual cirugía mínimamente invasiva en este grupo, no excluyéndolos únicamente por la edad como candidatos al tratamiento definitivo de su enfermedad [20][21][22] .…”

Conversion to Open Surgery in Laparoscopic Colorectal Cancer Resection: Predictive Factors and its Impact on Long-Term Outcomes. A Case Series Study

“…1,32,33 Given that colorectal cancer is the second most frequent type of cancer and that the majority of patients are older than 70-35% are older than 80-minimally invasive techniques are of particular interest in this population. 34 One of the controversial issues is the impact of conversion to open surgery on postoperative morbidity and long-term oncologic outcomes. Some authors have reported a negative impact of conversion on overall and disease-free survival while others have found no such differences.…”

“…Given that colorectal cancer is the second most frequent type of cancer and that the majority of patients are older than 70—35% are older than 80—minimally invasive techniques are of particular interest in this population 34…”