To evaluate the safety of the laparoscopic colorectal surgery to elderly patients with age over 75, a short-term result was examined.
From September 2002 to July 2008, 513 patients with tumors located in colon and/or rectosigmoid junction who underwent laparoscopic colorectal surgery in Shizuoka Cancer Center Hospital were studied. Patients with tumors located in rectum (Ra and Rb) were excluded from this study. Out of 513 patients, 89 patients age over 75 (76-90) were categorized as Group A, and 424 patients with age under 75 (29-75) were categorized as Group B. Intraoperative parameters (operation time, blood loss, and rate of conversion to the laparotomy) and post operative parameters (start date of oral intake, discharge date, and complication occurred within 30 days after operation) were compared in these two groups. There were no differences in distribution of gender and stages in these two groups. The incidence of chronic disease was significantly higher in Group A than that of Group B (70.8% vs 49.8%, p=0.0003).
The rate of conversion to laparotomy was significantly higher in Group A than in Group B (10.1% vs. 3.1%, p=0.007). However, there were no differences in blood loss and operation time between these two groups (66.0g vs. 48.5g, 211.6 min vs. 204.1 min, respectively). The main reason of conversion to the laparotomy was narrow field of view due to mesenteric fat and/or advanced adhesion. There were no significant differences in start date of oral intake (3.5 d vs. 3.4 d) and date of discharge (8.7 d vs. 8.7 d). The rate of surgical site infection was significantly higher in Group A than Group B (14.6% vs. 4.5%, p=0.0003). There were no significant differences in the rate of ileus (4.5% vs. 2.4%) and anastomotic leakage (1.1% vs. 3.1%) in these two groups.
The incidence of complications which leads to extend the hospital stays was not significantly higher in elderly patients. We think 10% of conversion rate in elderly patients is acceptable and the majority of elderly patients are candidates for laparoscopic colorectal surgery.
Program Number: P142