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Safety and Feasibility of a Laparoscopic Colorectal Cancer Resection in Elderly Patients

대한대장항문학회지 2013년 29권 1호 p.22 ~ 27
정덕현 ( Jeong Duck-Hyoun ) - Yonsei University College of Medicine Department of Surgery

 ( Hur Hyuk ) - Yonsei University College of Medicine Department of Surgery
 ( Min Byung-Soh ) - Yonsei University College of Medicine Department of Surgery
 ( Baik Seung-Hyuk ) - Yonsei University College of Medicine Department of Surgery
 ( Kim Nam-Kyu ) - Yonsei University College of Medicine Department of Surgery

Abstract


Purpose: The aim of this study is to assess the effects of age on the short-term outcomes of a laparoscopic resection of colorectal cancer in elderly (≥75 years old), as compared with younger (<75 years old), patients.

Methods: A retrospective analysis of patients who underwent laparoscopic surgery for colorectal cancer between January 2007 and December 2009 was performed. There were two groups: age <75 years old (group A) and age ≥75 years old (group B). The perioperative outcomes between group A and group B were compared.

Results: The study included 824 patients in group A and 92 patients in group B. The body mass index (BMI) and the American Society of Anesthesiologists (ASA) score were significantly different between group B and group A (BMI: 22.5 vs. 23.5, P = 0.002; ASA score: 1.88 vs. 1.48, P = 0.001). Mean operating times were similar between the groups (325.4 minutes vs. 351.6 minutes, P = 0.07). We observed a higher overall complication rate in group B than in group A (12.0% vs. 6.2%, P = 0.047), but the number of severe complications of Accordion Severity Classification ≥3 (those that required an invasive procedure) was not significantly different between the two groups (6.5% vs. 3.4%, P = 0.142). There was no significant difference in the length of hospital stay (13.0 days vs. 12.0 days, P = 0.053).

Conclusion: Although the elderly patients had a significantly higher overall postoperative complication rate, no significant difference was seen in either the number of severe complications of Accordion Severity Classification ≥3 or in the length of hospital stay. A laparoscopic colorectal cancer resection in elderly patients, especially those aged 75 years or older, is safe and feasible.

키워드

Colorectal cancer;Laparoscopic surgery;Elderly;Morbidity;Mortality
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