Laparoscopic resection of colorectal cancer in octogenarians

Abstract

BACKGROUND: Laparoscopic colorectal resection is becoming a trend in modern surgery. Studies have shown the benefit of having less post-operative pain, shorter hospital stays and faster recovery when comparing to open surgery. At the same time, people are living longer and the proportion of colorectal cancer in the elderly is increasing. They are generally having multiple co-morbidities and less physiological reserve than its younger counterparts. Whether or not laparoscopic surgery confers any benefit in this population is still debatable.

AIM: To evaluate the clinical outcomes of laparoscopic resection of colorectal cancer in patients over 80 years old.

PATIENTS and METHOD: It is a prospective study in a tertiary referral center. All elective resection of colorectal cancer in patients over 80 years old were included. From July 2000 to May 2007, there were 150 and 77 patients underwent open and laparoscopic resection of colorectal cancer respectively. Both groups are matched in basic demographics, ASA classifications, UICC staging, as well as co-morbidities. Primary outcome measures include 30-days mortality, overall and disease-free survival. Secondary outcome measures include operative time, blood loss, complication rates, hospital stay, and time to tolerate fluid diet.

RESULTS: There is no statistical significant difference in 30-days mortality, overall and disease-free survival between 2 groups. The median operative time for laparoscopic and open colorectal cancer resections is 160 and 120 minutes respectively ......