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Laparoscopic versus open colorectal resection in the elderly population

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Abstract

Background

Elderly patients are often regarded as high-risk patients for major abdominal surgery because of a lack of functional reserve and associated medical comorbidities. The aim of this systematic review and pooled analysis was to review the current data published regarding the differences in operative outcomes of laparoscopic and open surgery in the elderly population.

Methods

A systematic literature search of Medline, Embase, Web of Science, and Cochrane databases was performed. Studies that compared outcome following laparoscopic and open colorectal resections in the elderly (≥70) population were included. Primary outcomes were operative death, anastomotic leak, pneumonia, length of hospital stay, and return to bowel function. Secondary outcomes were operative time, intraoperative blood loss, postoperative cardiac morbidity, ileus, and postoperative wound infection.

Results

The results of this systematic review and pooled analysis demonstrate the safety and potential benefits of laparoscopic colorectal resection in the elderly population. The latter include reduction in length of hospital stay, intraoperative blood loss, incidence of postoperative pneumonia, time to return of normal bowel function, incidence of postoperative cardiac complications, and wound infections.

Conclusion

The results of this pooled analysis demonstrate the potential short-term advantages of laparoscopic colorectal resection in the elderly population. Further studies are required to examine the long-term survival following laparoscopic and open colorectal resections in the elderly population.

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Acknowledgments

We are grateful for support in part from the NIHR Biomedical Research Centre funding scheme.

Disclosures

Kate Grailey, Sheraz R. Markar, Alan Karthikesalingam, Rima Aboud, Paul Ziprin, and Omar Faiz have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Academic Surgical Unit, St. Mary’s Hospital, Imperial College Healthcare NHS Trust, Praed Street, London, UK

    Katherine Grailey, Sheraz R. Markar, Rima Aboud, Paul Ziprin & Omar Faiz

  2. Division of Surgery and Cancer, Imperial College London, London, UK

    Paul Ziprin & Omar Faiz

  3. Department of Vascular Surgery, St George’s Hospital, London, UK

    Alan Karthikesalingam

  4. St Marks Hospital, Northwick Park, London, UK

    Omar Faiz

Authors
  1. Katherine Grailey
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  2. Sheraz R. Markar
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  3. Alan Karthikesalingam
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  4. Rima Aboud
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  5. Paul Ziprin
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  6. Omar Faiz
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Correspondence to Omar Faiz.

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Grailey, K., Markar, S.R., Karthikesalingam, A. et al. Laparoscopic versus open colorectal resection in the elderly population. Surg Endosc 27, 19–30 (2013). https://doi.org/10.1007/s00464-012-2414-1

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  • DOI: https://doi.org/10.1007/s00464-012-2414-1

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