scholarly journals 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

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.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 ◽  
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.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Marius Kryzauskas ◽  
Augustinas Bausys ◽  
Justas Kuliavas ◽  
Klaudija Bickaite ◽  
Audrius Dulskas ◽  
...  

Abstract Background The proportion of elderly colorectal cancer (CRC) patients requiring surgery is increasing. Colorectal resection for left-sided cancers is the most controversial as the primary anastomosis or end-colostomy and open or minimally invasive approaches are available. Therefore, this study was conducted to investigate the short- and long-term outcomes in elderly patients after resection with primary anastomosis for left-sided CRC. Methods The cohort study included left-sided colorectal cancer patients who underwent resection with primary anastomosis. The participants were divided into non-elderly (≤75 years) and elderly (> 75 years) groups. Short- and long-term postoperative outcomes were investigated. Results In total 738 (82%) and 162 (18%) patients were allocated to non-elderly and elderly groups, respectively. Minimally invasive surgery (MIS) was less prevalent in the elderly (42.6% vs 52.7%, p = 0.024) and a higher proportion of these suffered severe or lethal complications (15.4% vs 9.8%, p = 0.040). MIS decreased the odds for postoperative complications (OR: 0.41; 95% CI: 0.19–0.89, p = 0.038). The rate of anastomotic leakage was similar (8.5% vs 11.7%, p = 0.201), although, in the case of leakage 21.1% of elderly patients died within 90-days after surgery. Overall- and disease-free survival was impaired in the elderly. MIS increased the odds for long-term survival. Conclusions Elderly patients suffer more severe complications after resection with primary anastomosis for left-sided CRC. The risk of anastomotic leakage in the elderly and non-elderly is similar, although, leakages in the elderly seem to be associated with a higher 90-day mortality rate. Minimally invasive surgery is associated with decreased morbidity in the elderly.


2016 ◽  
Vol 101 (11-12) ◽  
pp. 554-561
Author(s):  
Toru Aoyama ◽  
Masaaki Murakawa ◽  
Yosuke Atsumi ◽  
Keisuke Kazama ◽  
Manabu Shiozawa ◽  
...  

The short- and long-term outcomes of pancreatic resection for pancreatic adenocarcinoma have not been fully evaluated in elderly patients. This retrospective study selected patients who underwent curative surgery for pancreatic cancer at our institution. Patients were categorized into 2 groups: nonelderly patients (age &lt; 75 years; group A) and elderly patients (age ≥ 75 years; group B). The surgical morbidity, surgical mortality, overall survival (OS), and recurrence-free survival (RFS) rates in the 2 groups were compared. A total of 221 patients were evaluated in the study. The overall complication rates were 44.8% in group A and 52.6% in group B. Surgical mortality was observed in 2 patients due to an abdominal abscess and cardiovascular disease in group A (1.1%) and in 1 patient due to postoperative bleeding in group B (2.6%). There were no significant differences (P = 0.379 and P = 0.456, respectively). Furthermore, the 5-year OS and RFS rates were similar between the elderly patients and nonelderly patients (18.55 versus 20.2%, P = 0.946 and 13.1% versus 16.0%, P = 0.829, respectively). The short-term outcomes and long-term survival after pancreatic resection for pancreatic adenocarcinoma were almost equal in the elderly and the nonelderly patients in this study. Therefore, it is unnecessary to avoid pancreatic resection for pancreatic adenocarcinoma in elderly patients simply because of their age.


2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 470-470
Author(s):  
Keisuke Kazama ◽  
Toru Aoyama ◽  
Yosuke Atsumi ◽  
Masaaki Murakawa ◽  
Manabu Shiozawa ◽  
...  

470 Background: The short- and long-term outcomes of pancreatic resection for pancreatic adenocarcinoma have not been evaluated in elderly patients. Methods: This retrospective study selected patients who underwent curative surgery for pancreatic cancer at our institution. Patients were categorized into two groups; non-elderly patients(age <75 years: group A) and non-elderly patients (age ≥75 years: group B). The surgical morbidity, motality, overall survival (OS), and recurrence-free survival (RFS) rates in the two groups were compared. Results: A total of 221 patients were evaluated in the study. The overall complication rates are 44.8% in Group A and 52.6% in Group B. Surgical mortality was observed in 2 patients due to an abdominal abcess and cardiovascular disease in Group A (1.1%) and in 1 patient due to postoperative bleeding in Group B (2.6%). There were no significant differences (p=0.379 and p=0.456, respectively). Furthermore, the 5-year OS and RFS rates were similar between the elderly patients and non-elderly patients (18.55% vs. 20.2%, p=0.946 and 13.1% vs. 16.0%, p=0.829 respectively). Conclusions: The short-term outcomes and long-term outcomes survival after pancreatic resection for pancreatic adenocarcinoma were almost equal in the elderly and the non-elderly patients in this study. Therefore, it is unnecessary to avoid pancreatic resection for pancreatic adenocarcinoma in elderly patients simply because of their age.


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