Abstract
BackgroundRecently, 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.MethodsPatients 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.ResultsThe 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.ConclusionLaparoscopic 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.
Highlights
Colorectal cancer has increased in elderly patients worldwide, with laparoscopic colorectal surgery increasing in elderly patients with colorectal cancer
Most previous studies have reported only the technical safety and short-term outcomes of laparoscopic surgery in comparison with open surgery for elderly patients, but they did not include long-term outcomes. It is still unclear whether laparoscopic colorectal surgery is an optimal procedure for colorectal cancer in the elderly
There were no differences between LAC-E and OC-E groups in patient characteristics
Summary
Colorectal cancer has increased in elderly patients worldwide, with laparoscopic colorectal surgery increasing in elderly patients with colorectal cancer. In the treatment of colorectal cancer, laparoscopic surgery has developed rapidly throughout the world due to advantages such as smaller incision, less pain, reduced intraoperative blood loss, faster recovery, and shorter hospitalization compared with open surgery [5,6,7] These clinical benefits of laparoscopic surgery for colorectal cancer have been proved by a series of a large sample, multicenter, randomized controlled trials [8,9,10,11]. Most previous studies have reported only the technical safety and short-term outcomes of laparoscopic surgery in comparison with open surgery for elderly patients, but they did not include long-term outcomes. It is still unclear whether laparoscopic colorectal surgery is an optimal procedure for colorectal cancer in the elderly
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