Evaluation of short- and long-term outcomes following laparoscopic surgery for colorectal cancer in elderly patients aged over 80 years old: a propensity score-matched analysis

Author(s):  
Toshinori Sueda ◽  
Mitsuyoshi Tei ◽  
Kentaro Nishida ◽  
Yukihiro Yoshikawa ◽  
Tae Matsumura ◽  
...  
2020 ◽  
Author(s):  
Yoshitake Ueda ◽  
Norio Shiraishi ◽  
Takahide Kawasaki ◽  
Tomonori Akagi ◽  
Shigeo Ninomiya ◽  
...  

Abstract Background Recently, colorectal cancer has increased in elderly patients worldwide, with laparoscopic colorectal surgery increasing in elderly patients with colorectal cancer. However, whether laparoscopic colorectal surgery is an optimal procedure for colorectal cancer in the elderly remains unclear.Objective This study aimed to verify safety and curability of laparoscopic colorectal surgery in elderly patients ≥80 years old.Methods Patients undergoing curative colorectal surgery from 2006 to 2014 were enrolled and classified into the laparoscopic surgery in elderly patients aged ≥80 years (LAC-E) group, open surgery in elderly patients (OC-E) group, and laparoscopic surgery in non-elderly patients (LAC-NE) group. Short- and long-term outcomes were compared between these groups.Results The LAC-E, OC-E, and LAC-NE groups comprised 85, 25, and 358 patients, respectively. Intraoperative blood loss and incidence of postoperative complications were significantly lower in the LAC-E versus OC-E group (97 vs. 440 mL, p<.01 and 14% vs. 32%, p<.05, respectively). Long-term outcomes were not different between these two groups. Operation time was significantly shorter in the LAC-E versus LAC-NE group (249 vs. 288 min, p<.01). Intraoperative blood loss and postoperative complications were similar between the groups. Although the 5-year overall survival rate in the LAC-E group was lower than that in the LAC-NE group (64% vs. 80%, p<.01), there was no difference in 5-year disease-specific survival between the groups.Conclusions Laparoscopic colorectal surgery is technically and oncologically safe for colorectal cancer in the elderly as well as the non-elderly and can be an optimal procedure for colorectal cancer in the elderly.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Yoshitake Ueda ◽  
Norio Shiraishi ◽  
Takahide Kawasaki ◽  
Tomonori Akagi ◽  
Shigeo Ninomiya ◽  
...  

Abstract Background Recently, colorectal cancer has increased in elderly patients worldwide, with laparoscopic colorectal surgery increasing in elderly patients with colorectal cancer. However, whether laparoscopic colorectal surgery is an optimal procedure for colorectal cancer in the elderly remains unclear. This study aimed to verify safety and curability of laparoscopic colorectal surgery in elderly patients ≥80 years old. Methods Patients undergoing curative colorectal surgery from 2006 to 2014 were enrolled and classified into the laparoscopic surgery in elderly patients aged ≥80 years (LAC-E) group, open surgery in elderly patients (OC-E) group, and laparoscopic surgery in non-elderly patients (LAC-NE) group. Short- and long-term outcomes were compared between these groups. Results The LAC-E, OC-E, and LAC-NE groups comprised 85, 25, and 358 patients, respectively. Intraoperative blood loss and incidence of postoperative complications were significantly lower in the LAC-E versus OC-E group (97 vs. 440 mL, p < .01 and 14% vs. 32%, p < .05, respectively). Long-term outcomes were not different between these two groups. Operation time was significantly shorter in the LAC-E versus LAC-NE group (249 vs. 288 min, p < .01). Intraoperative blood loss and postoperative complications were similar between the groups. Although the 5-year overall survival rate in the LAC-E group was lower than that in the LAC-NE group (64% vs. 80%, p < .01), there was no difference in 5-year disease-specific survival between the groups. Conclusion Laparoscopic colorectal surgery is technically and oncologically safe for colorectal cancer in the elderly as well as the non-elderly and can be an optimal procedure for colorectal cancer in the elderly.


2020 ◽  
Author(s):  
Yoshitake Ueda ◽  
Norio Shiraishi ◽  
Takahide Kawasaki ◽  
Tomonori Akagi ◽  
Shigeo Ninomiya ◽  
...  

Abstract Background Recently, colorectal cancer has increased in elderly patients worldwide, with laparoscopic colorectal surgery increasing in elderly patients with colorectal cancer. However, whether laparoscopic colorectal surgery is an optimal procedure for colorectal cancer in the elderly remains unclear. This study aimed to verify safety and curability of laparoscopic colorectal surgery in elderly patients ≥80 years old. Methods Patients undergoing curative colorectal surgery from 2006 to 2014 were enrolled and classified into the laparoscopic surgery in elderly patients aged ≥80 years (LAC-E) group, open surgery in elderly patients (OC-E) group, and laparoscopic surgery in non-elderly patients (LAC-NE) group. Short- and long-term outcomes were compared between these groups. Results The LAC-E, OC-E, and LAC-NE groups comprised 85, 25, and 358 patients, respectively. Intraoperative blood loss and incidence of postoperative complications were significantly lower in the LAC-E versus OC-E group (97 vs. 440 mL, p<.01 and 14% vs. 32%, p<.05, respectively). Long-term outcomes were not different between these two groups. Operation time was significantly shorter in the LAC-E versus LAC-NE group (249 vs. 288 min, p<.01). Intraoperative blood loss and postoperative complications were similar between the groups. Although the 5-year overall survival rate in the LAC-E group was lower than that in the LAC-NE group (64% vs. 80%, p<.01), there was no difference in 5-year disease-specific survival between the groups. Conclusion Laparoscopic colorectal surgery is technically and oncologically safe for colorectal cancer in the elderly as well as the non-elderly and can be an optimal procedure for colorectal cancer in the elderly.


Surgery Today ◽  
2016 ◽  
Vol 47 (5) ◽  
pp. 587-594 ◽  
Author(s):  
Koki Otsuka ◽  
Toshimoto Kimura ◽  
Masanori Hakozaki ◽  
Mizunori Yaegashi ◽  
Teppei Matsuo ◽  
...  

2016 ◽  
Vol 27 ◽  
pp. 66-71 ◽  
Author(s):  
Katsuji Tokuhara ◽  
Kazuyoshi Nakatani ◽  
Yosuke Ueyama ◽  
Kazuhiko Yoshioka ◽  
Masanori Kon

Surgery Today ◽  
2019 ◽  
Vol 50 (6) ◽  
pp. 597-603
Author(s):  
Yuki Sakamoto ◽  
Yuji Miyamoto ◽  
Ryuma Tokunaga ◽  
Takahiko Akiyama ◽  
Nobuya Daitoku ◽  
...  

2020 ◽  
Author(s):  
Yih Jong Chern ◽  
Hsin-Yuan Hung ◽  
Jeng-Fu You ◽  
Yu-Jen Hsu ◽  
Jy-Ming Chiang ◽  
...  

Abstract Background: Laparoscopic surgery has achieved good results in elderly patients with colorectal cancer (CRC). In this study, we compared the short-term and long-term outcomes of open surgery and laparoscopic surgery in CRC patients aged above 75 years at a single tertiary medical center.Methods: Between January 2009 and December 2015, we studied 967 patients who underwent curative resection for primary colorectal adenocarcinoma without distant metastasis in a single institution. Of the enrolled subjects, 305 underwent laparoscopic surgery, and 662 received open laparotomy surgery.Results: Compared to the patients who received open surgery, those received laparoscopic surgery had prominent shorter postoperative stay (10.3 vs. 13.5 days p < 0.001) and similar postoperative mortality (p = 0.082) and morbidity (p = 0.354). In the laparoscopy cohort, 6 of 305 patients were converted to open surgery and 1 died. The long-term overall survival, cancer-specific survival and recurrence rate were all similar between both cohorts in each stage.Conclusions: Laparoscopic surgery is suitable for elderly patients due to shorter postoperative stay, similar long-term outcomes with open surgery and acceptably low conversion rates. For long-term overall and oncological outcome, the results of laparoscopic surgery were similar to that of open surgery in each TNM stage.


Cancers ◽  
2021 ◽  
Vol 14 (1) ◽  
pp. 131
Author(s):  
Yih-Jong Chern ◽  
Jeng-Fu You ◽  
Ching-Chung Cheng ◽  
Jing-Rong Jhuang ◽  
Chien-Yuh Yeh ◽  
...  

Advanced age is a risk factor for major abdominal surgery due to a decline in physical function and increased comorbidities. Although laparoscopic surgery provides good results in most patients with colorectal cancer (CRC), its effect on elderly patients remains unclear. This study aimed to compare the short- and long-term outcomes between open and laparoscopic surgeries in elderly patients with CRC. Total 1350 patients aged ≥75 years who underwent curative resection for stage I–III primary CRC were enrolled retrospectively and were divided into open surgery (846 patients) and laparoscopy (504 patients) groups. After propensity score weighting to balance an uneven distribution, a competing risk analysis was used to analyze the short-term and long-term outcomes. Postoperative mortality rates were lower in the laparoscopy group, especially due to pulmonary complications. Postoperative hospital stay was significantly shorter in the laparoscopy group than in the open surgery group. Overall survival, disease-free survival, and competing risk analysis showed no significant differences between the two groups. Laparoscopic surgery for elderly patients with CRC significantly decreased pulmonary-related postoperative morbidity and mortality in this large cohort study. Laparoscopic surgery is a favorable method for elderly patients with CRC than open surgery in terms of less hospital stay and similar oncological outcomes.


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