• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • COVID-19 Annoucements
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2023 Scientific Session Call For Abstracts
      • 2023 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • SAGES 2022
      • SAGES 2021
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Video Based Assessments (VBA)
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy-Coming Soon!
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Store
    • “Unofficial” Logo Products
  • Log In

Major elective laparoscopic colorectal resections can be performed in 80 to 90 year-old patients with low mortality at one year: An experience with 179 patients.

Nicolas Lopez-Acevedo, MD, Matthew N Johnson, BA, Austin D Williams, MD, Jessica R Pochedly, MD, Joseph L Frenkel, MD, John H Marks, MD. Lankenau Medical Center

Introduction

As the population ages, the need for surgery in patients older than 80 continues to increase. Fears regarding high operative mortality rates often hamper optimal surgical treatment of these patients. Minimally invasive surgery may offer a better option for these patients. Mindful that the one-year mortality for the general population of 84-year-olds in the U.S. is 8.4%, we evaluated short and long term mortality following laparoscopic colorectal resection in patients 80 or older.

Methods

From a prospective database containing 1768 laparoscopic colorectal surgeries performed between August 1996 and August 2014, we identified 189 patients 80 years and older. Patients not having a major resection were excluded, leaving 179 patients. This group was analyzed for perioperative morbidity and mortality rates at 30, 60, 90 days, 6, and 12 months. Causes of death were categorized as surgery-related, cancer-related, and unrelated to surgery. Patients’ disposition to home, nursing care or rehabilitation facility was recorded. A subset analysis for mortality was performed to compare outcomes of octogenarians and nonagenarians, diagnosis, procedure type, operative time, blood loss and by discharge status.

Results

Of 179 patients, 106 were women. Mean age was 83.9 years (80-95); 18 were > 90. Mean BMI was 25.2 (15.7-42.1). 52% had previous abdominal surgery. Diagnoses were 65.4% cancer, 14.5% polyp, 10.1% diverticulitis, 5.0% rectal prolapse, and 5.0% other. Procedures were pelvic TME (n=55), left colectomy (n=42), right colectomy (n=79), and other (n=3). Conversion to open was 2.8%. Morbidity rate was 29%; major morbidity rate was 12.8%. Anastomotic leak rate was 1.1%. Median discharge was POD #5 (1-46 days). 72% were discharged home, 18% to skilled nursing, 6% to rehabilitation facility, and 4% unknown. Overall 30-day and 1-year mortality was 0.6% and 9.8%, respectively. Cumulative mortality rates are shown in Table 1.

Table 1. Cumulative Mortality Rates.

30 Days 60 Days 90 Days 6 Months 12 Months
Overall Mortality Rate 0.6% 1.7% 3.4% 5.9% 9.8%
80-89 Year Old Mortality Rate 0.6% 1.3% 3.2% 5.9% 11.2%
≥ 90 Year Old Mortality Rate 0.0% 5.6% 5.6% 5.6% 6.2%

Mortality was surgery-related in 38%, cancer-related in 31%, and unrelated to surgery in 31%. Lower mortality rate was found in patients with OR time < 4 hrs vs. > 4hrs (P= 0.007), EBL of ≤ 200 mL vs. > 200 mL (P=0.009), and for right colectomy vs. TME/Left (P= 0.02). ASA classification, diagnosis and discharge disposition did not show statistically significant differences.

Conclusions

Major colorectal resections can be performed in 80+ year old patients with a low mortality laparoscopically. The 30 day mortality was <1%, mortality at 1 year was 9.8%, compared to an 8.4% annual mortality for the general population at 84. Median LOS was 5 days and 72% were discharged home. Minimally invasive colorectal surgery offers excellent outcomes in the elderly patient population and should be encouraged, not withheld, in the 80+ year old group.

69

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

« Return to SAGES 2015 abstract archive

Our Mission

Innovate, educate and collaborate to improve patient care.

Recently, on SAGES…

Critical View of Safety (CVS) Challenge QR Code

The SAGES Critical View of Safety Challenge – Donate Your Lap Chole Videos!

The Society of American Gastrointestinal and Endoscopic Surgeons is hosting the first Artificial Intelligence Data Challenge conducted by surgeons. The aim of this challenge is to generate a large and diverse dataset of laparoscopic cholecystectomy videos, annotated with respect to the subcomponents of the Critical View of Safety (CVS). Computer scientists from all over the […]

Respuesta de SAGES al Estudio NordICC sobre el beneficio de las colonoscopias de detección

SAGES desea aclarar los resultados del estudio NordICC y colocarlos en contexto de los esfuerzos de varias agencias nacionales para reducir el riesgo de cáncer colorrectal – la segunda causa de muerte por cáncer más frecuente en los Estados Unidos-, mediante la promoción de la detección y tratamiento oportuno de las lesiones.

SAGES Response to NordICC Study Regarding Benefit of Screening Colonoscopies

The NordICC Study recently published in The New England Journal of Medicine and widely reported on by media outlets has raised questions regarding the benefit of screening colonoscopy in lowering the risk of colorectal cancer and cancer-related deaths among otherwise healthy and symptom-free men and women aged 55 to 64. Provocative headlines and commentaries have […]

Contact SAGES

Society of American Gastrointestinal and Endoscopic Surgeons
11300 W. Olympic Blvd Suite 600
Los Angeles, CA 90064 USA
webmaster@sages.org
Tel: (310) 437-0544

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2023 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons