Safety of laparoscopic surgery for colorectal cancer in patients over 80 years old: a propensity score matching study

Shiga, Mai; Maeda, Hiromichi; Oba, Koji; Namikawa, Tsutomu; Fujisawa, Kazune; Yokota, Keiichiro; Kobayashi, Mariko; Hanazaki, Kazuhiro

doi:10.1007/s00595-017-1470-5

Cited by 25 publications

(11 citation statements)

References 18 publications

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“…While it is important to consider such variations in the analysis of surgical outcomes, the high thromboembolic risk patients in this study potentially underwent less-invasive surgery to prioritize surgical safety because such patients generally have comorbidities, resulting in poor surgical outcomes. Another study considered that the level of lymphadenectomy was reduced in elderly patients, likely to have comorbidities causing perioperative complications [20]. Those authors performed a propensity score-matching analysis using not only patient background but also surgical invasiveness, including the level of lymphadenectomy [20].…”

Section: Discussionmentioning

confidence: 99%

Is laparoscopic colorectal surgery with continuation of antiplatelet therapy safe without increasing bleeding complications?

et al. 2019

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PurposeThe number of patients on antiplatelet therapy (APT) who need surgery is increasing; however, it is unclear whether APT should be continued for abdominal surgery, particularly laparoscopic colorectal surgery. We investigated the safety of continuing APT for patients undergoing laparoscopic colorectal surgery.MethodsWe collected retrospective data from 529 patients who underwent laparoscopic colorectal surgery at Hiroshima University between January, 2013 and December, 2018. We analyzed information related to APT. Thirty-six pairs were matched by the propensity score method between patients on APT (APT+) and those not on APT (APT−). We compared the surgical outcomes of both groups.ResultsAmong 463 patients eligible for the study, 48 were on APT for cerebrovascular or cardiovascular disease, and 36 continued to take aspirin. In the case-matched comparison, the amount of intraoperative blood loss in the APT+ group was not significantly higher than that in the APT− group, and the incidences of bleeding complications, thromboembolic complications, and other complications were not significantly different between the groups.ConclusionIn a case-matched comparison, continuation of aspirin during laparoscopic colorectal surgery did not increase perioperative complications. In laparoscopic colorectal surgery, continuation of aspirin is an acceptable strategy for patients with thromboembolic risk caused by interruption of APT.

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Section: Discussionmentioning

confidence: 99%

Is laparoscopic colorectal surgery with continuation of antiplatelet therapy safe without increasing bleeding complications?

et al. 2019

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“…Shiga M and Ho B et al reviewed the laparoscopic surgery outcomes for elder CRC. They indicated better perioperative outcomes and similar complications with young ages [21,22]. Those results include not only operations, but also adjuvant therapy [23].…”

Section: Discussionmentioning

confidence: 99%

Maintenance Therapy for Elderly Colorectal Cancer Patients with Bevacizumab: Single Center Experience

Orita¹,

Koshiba²,

Kushida³

et al. 2018

Cancer Sci Res

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Background: Over the past decade, the outcome of treatment with chemotherapy for metastatic colorectal cancer (mCRC) is substantially better, with proven increases survival. However, many patients still suffer significant toxicities, such as peripheral neuropathy. In advanced countries, where most patients with mCRC are older, maintenance therapy is under study with the goal of reducing severe side effects and maintaining quality of life (QOL). Continuation of cytotoxic chemotherapy in the setting of accumulated toxicities is often not feasible, so less toxic drugs are needed over the long-term. Bevacizumab is one option that has low side effects and proven benefit when combined with chemotherapy. This report describes our experience in giving bevacizumab maintenance therapy to 11 older patients with mCRC and reviews maintenance therapy for mCRC. Materials and Methods:Baseline clinical characteristics, pre-specified bevacizumab-related adverse events, and efficacy data were collected from the local patient registry. Approval was provided by the Juntendo University Hospital Institutional Review Board. Results: Eleven patients received maintenance therapy after FOLFOX and/or FOLFIRI regimens for an average of 476 days. Maintenance therapy was instituted due to several side effects from oxaliplatin-based chemotherapy.Side effect included such as peripheral neuropathy and fatigue could reduce during maintenance therapy and get QOL until end stage.Conclusions: Our experience with these 11 patients, demonstrates both prolonged survival as well as maintained QOL. Bevacizumab based maintenance therapy may be considered in elderly patients with mCRC.

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“…Рядом исследователей, преимущественно из крупных высокоспециализированных центров Южной Кореи и Японии, показано, что плановые лапароскопические резекции толстой кишки у больных старческого возраста достаточно безопасны: показатели послеоперационной летальности и частоты осложнений составляют обычно 0-1 и 22-30% соответственно, а отдаленная выживаемость идентична выживаемости пациентов, перенесших открытые операции [13,14]. Европейскими исследователями, в частности специалистами из университетской клиники Лозанны под руководством проф.…”

Section: Discussionunclassified

Results of radical laparoscopic surgery for colorectal cancer in elderly and senile patients

Lyadov¹,

Кочатков²,

Negardinov³

et al. 2017

Onkol. Z. im. P.A. Gercena

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Цель исследования-анализ ближайших результатов радикальной лапароскопической резекции толстой кишки у пациентов пожилого и старческого возраста. Материал и методы. Проведен ретроспективный анализ результатов 251 лапароскопической резекции толстой кишки за период с марта 2009 г. по декабрь 2015 г. Выполнено сравнение частоты осложнений по классификации Dindo-Clavien, летальности, длительности послеоперационного койко-дня в различных возрастных группах пациентов: до 60, 60-69, 70-79, 80 лет и старше, которым произведено 89, 82, 65 и 14 операций соответственно. Результаты. Различий между группой пациентов молодого возраста и больными 60-69 и 70-79 лет не получено. Однако у пациентов в возрасте 80 лет и старше отмечено значимое (р<0,05) увеличение частоты несостоятельности анастомозов, тяжелых осложнений (Dindo-Clavien III-IV) и летальности, а также увеличение средней продолжительности послеоперационного койко-дня. Заключение. Проведение лапароскопической резекции толстой кишки у пациентов пожилого возраста безопасно. Однако больные самой старшей возрастной группы требуют особенно тщательной предоперационной подготовки и детального планирования операции. Ключевые слова: колоректальный рак, пожилой и старческий возраст, лапароскопическая резекция.

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Safety of laparoscopic surgery for colorectal cancer in patients over 80 years old: a propensity score matching study

Abstract: The findings of the present study demonstrate that laparoscopic surgery for colorectal cancer should not be avoided based on simply the age of the patient.

Cited by 25 publications

References 18 publications

Is laparoscopic colorectal surgery with continuation of antiplatelet therapy safe without increasing bleeding complications?

Is laparoscopic colorectal surgery with continuation of antiplatelet therapy safe without increasing bleeding complications?

Maintenance Therapy for Elderly Colorectal Cancer Patients with Bevacizumab: Single Center Experience

Results of radical laparoscopic surgery for colorectal cancer in elderly and senile patients

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