Midterm follow-up of a randomized trial of open surgery versus laparoscopic surgery in elderly patients with colorectal cancer

Background. The present study aimed to compare the clinical outcomes of laparoscopic versus open surgery for colorectal cancers.Materials and Methods. The medical records from a total of 163 patients who underwent surgery for colorectal cancers were retrospectively analyzed. Patient’s demographic data, operative details and postoperative early outcomes, outpatient follow-up, pathologic results, and stages of the cancer were reviewed from the database.Results. The patients who underwent laparoscopic surgery showed significant advantages due to the minimally invasive nature of the surgery compared with those who underwent open surgery, namely, less blood loss, faster postoperative recovery, and shorter postoperative hospital stay (P<0.05). However, laparoscopic surgery for colorectal cancer resulted in a longer operative time compared with open surgery (P<0.05). There were no statistically significant differences between groups for medical complications (P>0.05). Open surgery resulted in more incisional infections and postoperative ileus compared with laparoscopic surgery (P<0.05). There were no differences in the pathologic parameters between two groups (P<0.05).Conclusions. These findings indicated that laparoscopic surgery for colorectal cancer had the clear advantages of a minimally invasive surgery and relative disadvantage with longer surgery time and exhibited similar pathologic parameters compared with open surgery.

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Advantage of laparoscopy surgery for elderly colorectal cancer patients without compromising oncologic outcome

10.21203/rs.3.rs-27987/v2 ◽

2020 ◽

Author(s):

Yih Jong Chern ◽

Hsin-Yuan Hung ◽

Jeng-Fu You ◽

Yu-Jen Hsu ◽

Jy-Ming Chiang ◽

...

Keyword(s):

Colorectal Cancer ◽

Laparoscopic Surgery ◽

Elderly Patients ◽

Open Surgery ◽

Medical Center ◽

Postoperative Mortality ◽

Long Term Outcomes ◽

Postoperative Stay ◽

Conversion Rates

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.

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Decreasing Postoperative Pulmonary Complication Following Laparoscopic Surgery in Elderly Individuals with Colorectal Cancer: A Competing Risk Analysis in a Propensity Score–Weighted Cohort Study

Cancers ◽

10.3390/cancers14010131 ◽

2021 ◽

Vol 14 (1) ◽

pp. 131

Author(s):

Yih-Jong Chern ◽

Jeng-Fu You ◽

Ching-Chung Cheng ◽

Jing-Rong Jhuang ◽

Chien-Yuh Yeh ◽

...

Keyword(s):

Colorectal Cancer ◽

Laparoscopic Surgery ◽

Risk Analysis ◽

Elderly Patients ◽

Open Surgery ◽

Competing Risk ◽

Competing Risk Analysis ◽

Long Term Outcomes ◽

Laparoscopy Group

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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Advantage of Laparoscopy Surgery for Elderly Colorectal Cancer Patients without Compromising Oncologic Outcome

10.21203/rs.3.rs-27987/v1 ◽

2020 ◽

Author(s):

Yih Jong Chern ◽

Hsin-Yuan Hung ◽

Jeng-Fu You ◽

Yu-Jen Hsu ◽

Jy-Ming Chiang ◽

...

Keyword(s):

Colorectal Cancer ◽

Laparoscopic Surgery ◽

Elderly Patients ◽

Open Surgery ◽

Medical Center ◽

Postoperative Mortality ◽

Long Term Outcomes ◽

Postoperative Stay ◽

Conversion Rates

Abstract Backgrounds: 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.

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Influence of previous abdominal surgery on surgical outcomes between laparoscopic and open surgery in elderly patients with colorectal cancer: subanalysis of a large multicenter study in Japan

Journal of Gastroenterology ◽

10.1007/s00535-016-1262-5 ◽

2016 ◽

Vol 52 (6) ◽

pp. 695-704 ◽

Cited By ~ 7

Author(s):

Seiichiro Yamamoto ◽

◽

Takao Hinoi ◽

Hiroaki Niitsu ◽

Masazumi Okajima ◽

...

Keyword(s):

Colorectal Cancer ◽

Abdominal Surgery ◽

Elderly Patients ◽

Multicenter Study ◽

Surgical Outcomes ◽

Open Surgery ◽

Previous Abdominal Surgery ◽

Large Multicenter Study ◽

Surgery In Elderly

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Advantage of laparoscopy surgery for elderly colorectal cancer patients without compromising oncologic outcome

10.21203/rs.3.rs-27987/v3 ◽

2020 ◽

Author(s):

Yih Jong Chern ◽

Hsin-Yuan Hung ◽

Jeng-Fu You ◽

Yu-Jen Hsu ◽

Jy-Ming Chiang ◽

...

Keyword(s):

Colorectal Cancer ◽

Laparoscopic Surgery ◽

Elderly Patients ◽

Open Surgery ◽

Medical Center ◽

Long Term Outcomes ◽

Cancer Specific Survival ◽

Postoperative Stay ◽

Conversion Rates

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

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Short- and Long-Term Outcomes of Laparoscopic Surgery for Colorectal Cancer in the Elderly Aged Over 80 Years Old Versus Non-Elderly: A Retrospective Cohort Study

10.21203/rs.3.rs-36719/v1 ◽

2020 ◽

Author(s):

Yoshitake Ueda ◽

Norio Shiraishi ◽

Takahide Kawasaki ◽

Tomonori Akagi ◽

Shigeo Ninomiya ◽

...

Keyword(s):

Colorectal Cancer ◽

Laparoscopic Surgery ◽

Colorectal Surgery ◽

Elderly Patients ◽

Laparoscopic Colorectal Surgery ◽

The Elderly ◽

Long Term Outcomes ◽

Short And Long Term ◽

Surgery In Elderly

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.

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