Abstract
Background
The incidence of colorectal carcinoma increases in the elderly. Regardless of age as an isolated factor, postoperative complications represent the main factor in increasing hospital mortality.
Methods
The aim of this study was to compare the short-term results (first 30 postoperative days) after laparoscopically assisted colectomy (LAC) and open segmental colectomy (OC) in colorectal carcinoma between two groups of patients, older than 70 and younger than 70 years of age. In the study from November 1993 to June 1998, 255 patients were evaluated to participate.
Results
Peristalsis, oral intake, and discharge from the hospital occurred earlier in LAC than in OC treated patients, in the two age groups. The mean operative time was significantly longer in the LAC than in the OC patients in the two age groups. No differences were observed in morbidity between LAC and OC in the group younger than 70 years of age. However, the overall morbidity was significantly lower in the LAC group in patients older than 70 years. One patient in the LAC group older than 70 years died.
Conclusion
These results suggest that laparoscopically assisted colectomy may be particularly indicated in elderly patients.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Adloff M, Ollier JC, Schloegel M, Arnaud JP, Serrat M (1993) Le cancer colo-rectal chez les sujets de plus de 80 ans. Ann Chir 6: 492–496
Brooks B (1937) Surgery in patients of advanced age. Ann Surg 105: 481–495
Bufalari A, Ferri M, Cao P, Cirocchi R, Bisacci R, Moggi L (1996) Surgical care in octagenarians. Br J Surg 83: 1783–1787
Calabrese CT, Adam YG, Volk H (1973) Geriatric colon cancer. Am J Surg 125: 181–184
Crosa MJ, Snyder SK (1993) Laparoscopic directed small bowel resection for duodenal diverticulitis with perforation. J Laparoendosc Surg 3: 47–49
Fabre JM, Rouanet P, Ele N, Fagot H, Guillon F, Deixonne B, Balmes M, Domergue J, Baumel H (1993) Colorectal carcinoma in patients aged 75 years and more: factors influencing short- and long-term operative mortality. Int Surg 78: 200–203
Fielding LP, Phillips RKS, Hittinger R (1989) Factors influencing mortality after curative resection for large bowel cancer in elderly patients. The Lancet 18: 595–597
Greenburg AG, Saik RP, Coile JJ, Peskin GW (1981) Mortality and gastrointestinal surgery in the aged: elective vs emergency procedures. Arch Surg 116: 788–791
Gutt CN, Kuntz C, Schmandra Th, Wunsch A, Heinz P, Bouvy N, Bessler M, Sänger Ph, Bonjer J, Allendorf J, Jacobi CA, Whelan R (1998) Metabolism and immunology in laparoscopy. Surg Endosc 12: 1096–1098
Lacy AM, García Valdecasas JC, Delgado S, Grande L, Fuster J, Tabet J, Ramos C, Piqué JM, Cifuentes JA, Visa J (1997) Postoperative complications of laparoscopic-assisted colectomy. Surg Endoc 11: 119–122.
Lacy AM, García Valdecasas JC, Piqué J, Delgado S, Campo E, Bordas JM, Taurá P, Grande L, Fuster J, Pacheco JL, Visa J (1995) Short-term outcome analysis of a randomized study comparing laparoscopic versus open colectomy for colon cancer. Surg Endosc 9: 1101–1105
Linn B, Linn M, Wallen N (1982) Evaluation of results of surgical procedures in the elderly. Ann Surg 195: 90–96
Munro W, Avramovic J, Rohey W (1993) Laparoscopic rectopexy. J Laparoendosc Surg 3: 55–58
O’Rourke NA, Heald RJ (1993) Laparoscopic surgery for colorectal cancer. Br J Surg 80: 1229–1230
Ostman PL, Pantle-Fisher FH, Faure EA, Glosten B (1990) Circulatory collapse during laparoscopy. J Clin Anesthesiol 2: 129–132
Payne JE, Chapuis PH, Pheils MT (1986) Surgery for large bowel cancer in people aged 75 years and older. Dis Col Rect 29: 733–737
Peters WR, Fleshman JW (1995) Minimally invasive surgery in elderly patients. Surg Laparosc Endosc 5: 477–479
Reissman P, Agachan F, Wexner SD (1996) Outcome of laparoscopic colorectal surgery in older patients. Am Surg 62: 1060–1063
Seymour DG, Vaz FG (1987) Aspects of surgery in the elderly: preoperative medical assessment. Br J Hosp Med 37: 102–112
Spivak H, Van de Maele D, Friedman Y, Nussbaum M (1996) Colorectal surgery in octogenarians. J Am Col Surg 183: 46–50
Sundin JA, Wasson D, McMillen MM, Ballantyne GH (1992) Laparoscopic assisted sigmoid colectomy for sigmoid volvulus. Surg Laparosc Endosc 2: 353–358
Wexner S, Reissman P, Bernstein M, Geron N (1996) Laparoscopic colorectal surgery: analysis of 140 cases. Surg Endosc 10: 133–136
Wise WE, Padmanabhan A, Meesig DM, Arnold MW, Aguilar PS, Stewart WR (1991) Abdominal colon and rectal operations in the elderly. Dis Colon Rectum 34: 959–963
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Delgado, S., Lacy, A.M., Valdecasas, J.C.G. et al. Could age be an indication for laparoscopic colectomy in colorectal cancer?. Surg Endosc 14, 22–26 (2000). https://doi.org/10.1007/s004649900004
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/s004649900004