Comparison of Laparoscopic Colectomy and Conventional Open Colectomy in Elderly Patients

Abstract

Purpose. The increased incidence of colorectal diseases with advancing age is accompanied by higher mortality, morbidity and prolonged hospital stay in these patients after open colorectal surgery. This study compared the short-term outcomes between elderly patients (aged 70 and above) who received laparoscopic colorectal surgery and those who received open colorectal surgery. Methods. A total of 74 patients with colorectal cancer with age above 70 were included in this retrospective analysis. The results of laparoscopic assisted colectomy (LAC) and conventional open colectomy (OC) were compared. Results. The LAC group included 11 males and 16 females, with the mean age of 77.3±5.2 (range, 71-90). The OC group included 25 males and 22 females with a mean age of 75.8±4.8 (range, 70-87). The mean duration from surgery to the start of diet was earlier in the LAC group than that in the OC group (4.6±2.8 days v.s. 6.5±2.3 days, p＜0.05).The mean duration of hospitalization was also shorter in the LAC group than that in the OC group (14.5±6.0 days v.s. 19.4±9.3 days, p＜0.05). The mean intra-operative blood loss in the LAC was less than that in the OC group (105.6±300.8mL v.s. 265.3±268.1mL, p＜0.05). There was no significant difference in mean operation time and postoperative complications between the two groups. Conclusions. Laparoscopic colectomy in selected elderly patients was associated with less intra-operative blood loss, earlier start of diet and shorter hospital stays. These data suggest laparoscopic colorectal procedures in the elderly population may be associated with a trend toward better clinical efficacy and cost effectiveness.