Surgical management of colorectal cancer for the aging population—A survey by the Japanese Society for Cancer of Colon and Rectum

Matsuoka, Hiroshi; Maeda, Kotaro; Hanai, Taizo; Sato, Harunobu; Masumori, Koji; Koide, Y.; Katsuno, Hidetoshi; Endo, Tomoyoshi; Shiota, Miho; Sugihara, Kenichi

doi:10.1016/j.asjsur.2016.10.001

Cited by 11 publications

(6 citation statements)

References 11 publications

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“…Alves et al reported that early stoma closure on day 8 after initial surgery was feasible, with reduced hospital stay, bowel obstruction, and medical complications [13]. However, the recruited patients were young, with a mean age of 58 years, and seemed to have clinical characteristics different from those of subjects in our country [14,15] and institutes [16]. Although colorectal surgery has been proven to be safe in elderly patients [16], repeated surgical interventions within a short period of time must be carefully assessed in patients with poor general health.…”

Section: Introductionmentioning

confidence: 80%

The safety of early versus late ileostomy reversal after low anterior rectal resection: a retrospective study in 47 patients

et al. 2021

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Background This study aimed to clarify the safety of early closure in diverting ileostomy with lower anterior rectal-cancer resection. Methods We retrospectively reviewed consecutive 47 patients who underwent diverting ileostomy with lower rectal-cancer resection between May 2009 and October 2017. The results of the stoma closure were compared between patients who underwent stoma closure within 90 days (early closure [EC] group) and those who underwent late closure (LC group; closure after 90 days). Because of the small sample size, the frequency of severe complications post closure was analyzed. Results Among 47 patients, 29 were in the EC group. Postoperative complications occurred in 48.3% (14/29) and 27.8% (5/18) of patients in the EC and LC groups, respectively. This difference was due to minor complications (Clavien-Dindo Classification I/II), such as superficial incisional surgical site infections (n=5) in the EC group. The rate of severe complications (Clavien-Dindo Classification ≥ III) was similar between the groups (20.7% vs. 16.7%, p=1, Fisher’s exact test). Conclusions No association was observed between the time of closure and development of major complications; however, there was an increased likelihood of minor complications after EC. This study provides a basis on which future treatment guidelines for early stoma closure may be developed without affecting patient quality of life.

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Section: Introductionmentioning

confidence: 80%

The safety of early versus late ileostomy reversal after low anterior rectal resection: a retrospective study in 47 patients

et al. 2021

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“…7 According to the Japanese Society for Cancer of the Colon and Rectum, the Eastern Cooperative Oncology Group performance status should be used for preoperative assessments, and electrocardiograms and ultrasonic cardiograms are used for the evaluation of cardiac function. 16 We usually use these methods to assess preoperative risk. 6 In addition, the ASA-PS is important in decision making regarding…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Surgery for Colorectal Cancer in Super-Elderly Patients: A Single-Center Analysis

Hashida

Mizuno²,

Iwaki³

et al. 2020

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Background: Super-elderly patients with colorectal cancer are being encountered with increasing frequency in Japan. Laparoscopic surgery is considered a less invasive surgery in these patients; however, it is difficult to conduct controlled clinical trials in this super-elderly population. This study assessed the feasibility and safety of laparoscopic colorectal surgery in patients over 85 years old.Materials and Methods: Open and laparoscopic surgeries for colorectal cancer in super-elderly patients (aged 85 y and older) were performed under general anesthesia in a single medical center. Records were retrospectively reviewed, and the clinicopathologic features of each patient and the surgical time and outcomes were recorded and analyzed.Results: Records of colorectal surgery were reviewed for 108 super-elderly patients. Twenty-six open surgeries and 82 laparoscopic surgeries were performed. The mean operation times were 215 and 228 minutes in open and laparoscopic surgeries, respectively. Intraoperative bleeding in laparoscopic surgery was lesser than that in open surgery. There were 2 cases with major postoperative complications in open surgery, and mortality occurred in one case within 1 month after surgery. No major complications were observed in laparoscopic surgery. In survival analysis, disease-free survival did not differ between the 2 groups. The oldest patient was a man aged 102 years and 6 months who underwent laparoscopic anterior resection with lymph node dissection. Conclusion:Laparoscopic surgery in super-elderly patients with colon cancer is feasible and safe. The authors report the success of laparoscopic colectomy for rectosigmoid colon cancer in the oldest known patient and the positive outcomes of laparoscopic colectomy in super-elderly patients.

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“…However, this approach seemed to overestimate the postoperative risk of mortality among their cohort . According to a survey by the Japanese Society for Cancer of the Colon and Rectum, PS is often used for preoperative assessments, and electrocardiograms and ultrasonic cardiograms are used for cardiovascular evaluations at many institutions . We use the same methods for preoperative assessments.…”

Section: Discussionmentioning

confidence: 99%

Successful laparoscopic treatment of advanced rectal cancer in an extremely elderly man (101 years and 9 months)

Nagai¹,

Togo²,

Nakagi³

et al. 2017

Asian J Endoscop Surgery

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An extremely elderly man (age, 101 years and 9 months) visited our hospital because of recurrent and worsening anal bleeding. Type 2 rectal cancer was found in his rectum during colonoscopy. He did not have any severe coexisting diseases and had not suffered any episodes of dementia. Laparoscopy-assisted anterior resection combined with D2 lymph node dissection was performed with minimal bleeding. The operation time was 128 min. The patient suffered mild reflux pneumonia on postoperative day 6 and was administered additional antibiotics. He recovered within 2 days. He was discharged on postoperative day 17, at which point he was able to walk.

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Surgical management of colorectal cancer for the aging population—A survey by the Japanese Society for Cancer of Colon and Rectum

Abstract: Japanese Society for Cancer of the Colon and Rectum member institutions often used the same surgical treatment strategies for both elderly and younger patients with the exception of performing intersphincteric resection.

Cited by 11 publications

References 11 publications

The safety of early versus late ileostomy reversal after low anterior rectal resection: a retrospective study in 47 patients

The safety of early versus late ileostomy reversal after low anterior rectal resection: a retrospective study in 47 patients

Laparoscopic Surgery for Colorectal Cancer in Super-Elderly Patients: A Single-Center Analysis

Successful laparoscopic treatment of advanced rectal cancer in an extremely elderly man (101 years and 9 months)

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