Indications for laparoscopic surgery for older rectal cancer patients with comorbidities.

Abstract

Given the lack of safety studies concerning laparoscopic surgery for rectal cancer in patients ≥ 80years old with comorbidities, we sought to investigate this in the current study. Between 2012 and 2019, 24 patients ≥ 80years old underwent laparoscopic surgery for rectal cancer without preoperative treatment. These patients were divided into those with [comorbidity(+) group, n = 13] and without [comorbidity(-) group, n = 11] comorbidities. The preoperative nutritional status and ASA classification, postoperative complications, time to oral diet, and length of hospital stay were evaluated in each group. In the comorbidity(+)/comorbidity(-) groups, the average age was 85.9/84.1years old, respectively. The major comorbidities were heart disease including atrial fibrillation and valvular disorder. The average PNI and CONUT scores in the comorbidity(+)/comorbidity(-) groups were 44.7/44.2 an 3.1/2.2, respectively. Planned surgical procedures were completed in all patients. Postoperative complications occurred in 2/3 cases in the comorbidity(+)/comorbidity(-) groups, respectively, and the average time to oral diet was 3.8/3.7days, while the average length of hospitalization after surgery was 15.2/16.5days, respectively. In the comorbidity(+) group, there was no exacerbation of comorbidities in any cases. The safety of laparoscopic surgery is acceptable among older rectal cancer patients with comorbidities.