Risk Factors for Postoperative Complications in Elderly After Colorectal Cancer Resection

This study aimed to assess perioperative morbidity and mortality in elderly patients following colorectal cancer resection and to investigate risk factors for postoperative complications. This study reviewed 697 consecutive patients who underwent elective colorectal cancer resection between 2005 and 2013 at our institution. Patients were divided into 3 groups according to their age: ≤74 (n = 420), 75 to 89 (n = 261), and ≥90 years (n = 16). Clinical findings, morbidity, and mortality were compared among these groups. Univariate and multivariate logistic regression analyses were performed with clinically relevant variables for the complications that increased with aging. Postoperative delirium and pneumonia showed significant increases with aging. There were no significant differences in mortality and morbidity among the 3 groups, except for the 2 aforementioned diseases. Multiple logistic regression analysis showed that dementia and laparoscopic surgery were independent determinants of postoperative delirium and that age and American Society of Anesthesiologists (ASA) score were independent risk factors for postoperative pneumonia. Dementia, high ASA score, and age were the risk factors for higher postoperative morbidity in elderly patients. Our results demonstrated the effectiveness of laparoscopic surgery for the prevention of postoperative delirium after colorectal resection.

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Incidence and risk factors of postoperative delirium in elderly patients who underwent laparoscopic surgery for colorectal cancer

International Journal of Colorectal Disease ◽

10.1007/s00384-015-2335-2 ◽

2015 ◽

Vol 31 (1) ◽

pp. 67-73 ◽

Cited By ~ 21

Author(s):

Mitsuyoshi Tei ◽

Masaki Wakasugi ◽

Kentaro Kishi ◽

Masahiro Tanemura ◽

Hiroki Akamatsu

Keyword(s):

Colorectal Cancer ◽

Risk Factors ◽

Laparoscopic Surgery ◽

Elderly Patients ◽

Postoperative Delirium

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Identification of the Risk Factors for Postoperative Complications in Elderly Patients with Colorectal Cancer

Nippon Daicho Komonbyo Gakkai Zasshi ◽

10.3862/jcoloproctology.69.191 ◽

2016 ◽

Vol 69 (4) ◽

pp. 191-196

Author(s):

Sho Sawazaki ◽

Yasushi Rino ◽

Hirohide Inoue ◽

Norio Yukawa ◽

Munetaka Masuda

Keyword(s):

Colorectal Cancer ◽

Risk Factors ◽

Postoperative Complications ◽

Elderly Patients

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Effect of Age on Laparoscopic Surgery and Postoperative Chemotherapy in Elderly Patients With Colorectal Cancer

Annals of Coloproctology ◽

10.3393/ac.2019.10.03 ◽

2020 ◽

Vol 36 (4) ◽

pp. 229-242 ◽

Cited By ~ 1

Author(s):

Hyun Hee Kim ◽

Myong Hoon Ihn ◽

Yun Hee Lee ◽

Jihyoun Lee ◽

Sangchul Yun ◽

...

Keyword(s):

Colorectal Cancer ◽

Laparoscopic Surgery ◽

Postoperative Complications ◽

Adverse Events ◽

Elderly Patients ◽

Chemotherapy Regimen ◽

Postoperative Chemotherapy ◽

Smoking History ◽

Curative Intent ◽

Physical Status Classification

Purpose: We aimed to evaluate the postoperative complications of laparoscopic colorectal cancer (CRC) surgery and the adverse events of postoperative chemotherapy in elderly patients compared to younger patients and to identify the factors influencing the termination of postoperative chemotherapy.Methods: Between June 2015 and May 2018, 188 patients with CRC underwent laparoscopic surgery with curative intent. Patients aged ≥ 70 were defined as elderly. Postoperative complications and adverse events of chemotherapy were assessed by using the Clavien-Dindo classification and the Common Terminology Criteria for Adverse Events, respectively. The clinicopathological factors were analyzed retrospectively.Results: Seventy-eight patients were considered elderly with a mean age of 77.5 ± 5.5 years. Overall postoperative complications occurred in 68 patients (36.2%). Age and primary tumor location were independent predictors of overall postoperative complications. Smoking history was the only independent predictor of major postoperative complications. Of 113 patients who were recommended postoperative chemotherapy, 90 patients (79.6%) received postoperative chemotherapy. Overall adverse events occurred in 40 patients (44.4%). The American Society of Anesthesiologists physical status classification and chemotherapy regimen were significantly associated with overall adverse events. The chemotherapy regimen was the only factor significantly associated with severe adverse events. Of 90 patients, postoperative chemotherapy could not be completed in 11 (12.2%). Age was the only factor significantly associated with stopping postoperative chemotherapy (P = 0.003).Conclusion: This study shows that laparoscopic CRC surgery and postoperative chemotherapy were feasible in elderly patients. Further efforts are needed to ensure that elderly patients have the opportunity to make informed decisions regarding postoperative chemotherapy.

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