Short-Term Outcome of Laparoscopic Colorectal Cancer Surgery in Elderly Patients

Kazuki Ueda, MD, Haruhiko Imamoto, MD, Kiyotaka Okuno, MD, Fumiaki Sugiura, MD, Koji Daito, MD, Shigeru Hatabe, MD, Takehito Yoshifuji, MD, Eizaburo Ishimaru, MD, Tadao Tokoro, MD, Jin-ichi Hida, MD, Hitoshi Shiozaki, MD. Kinki University School of Medicine

Aim: The object of this retrospective study was to assess the outcome of laparoscopic colorectal cancer surgery in patients >or= 75 years of age and compare it to a younger patients (<75 years) who underwent similar procedures.
Study design: Among 210 consecutive patients who had elective laparoscopic colorectal cancer surgery from January 2005 to May 2010 were included. The operation was performed or supervised by 1 surgeon (KU). The parameters analyzed included patient demographics, tumor characteristics, procedures, conversions, complications, length of hospitalization, and comorbidities.
Results: Fifty patients were 75 years of age or older (elderly group, mean age 80 (75-88); 27 males and 23 females) and were compared with 160 younger patients (younger group, mean age 63 (19-74); 95 males and 65 females). Thirty-four patients (68%) in the elderly group had comorbid conditions including such as hypertension, chronic heart failure, chronic renal failure, post brain infarction, diabetes mellitus, and obstructive pulmonary disease comparison to 65 patients (41%) in the younger group. There were similar tumor location, tumor stage, and performed procedures in two groups. There were no statistically significant differences between the elderly and younger groups with regard to mean operating time (189±10 vs. 204± 6 min, NS), established blood loss (102±24 vs. 81±13 g, NS), the incidence of per- (4.0 vs. 6.3%, NS) and post- (28.0 vs. 17.5%, NS) operative complications, conversion (10 vs. 10%, NS). However, postoperative mean hospital stay was significantly longer in the elderly group (15 vs. 11 days, p=0.02) because of delayed recovery of cardiopulmonary comorbidities.
Conclusions: The outcome of laparoscopic surgery in elderly patients is favorable. However, postoperative recovery was slightly longer in elderly patients. More detail results and considerations will be presented at the meeting including previously published literature.