Surgical Endoscopy

, Volume 22, Issue 2, pp 401–405

Do elderly patients benefit from laparoscopic colorectal surgery?

  • B. Person
  • S. M. Cera
  • D. R. Sands
  • E. G. Weiss
  • A. M. Vernava
  • J. J. Nogueras
  • S. D. Wexner
Article

DOI: 10.1007/s00464-007-9412-8

Cite this article as:
Person, B., Cera, S.M., Sands, D.R. et al. Surg Endosc (2008) 22: 401. doi:10.1007/s00464-007-9412-8

Abstract

Background

The steadily increasing age of the population mandates that potential benefits of new techniques and technologies be considered for older patients.

Aim

To analyze the short-term outcomes of laparoscopic (LAP) colorectal surgery in elderly compared to younger patients, and to patients who underwent laparotomy (OP).

Methods

A retrospective analysis of patients who underwent elective sigmoid colectomies for diverticular disease or ileo-colic resections for benign disorders; patients with stomas were excluded. There were two groups: age < 65 years (A) and age ≥ 65 years (B). Parameters included demographics, body mass index (BMI), length of operation (LO), incision length (LI), length of hospitalization (LOS), morbidity and mortality.

Results

641 patients (M/F – 292/349) were included between July 1991 and June 2006; 407 in group A and 234 in group B. There were significantly more LAP procedures in group A (244/407 – 60%) than in group B (106/234 – 45%) – p = 0.0003. Conversion rates were similar: 61/244 (25%) in group A, and 25/106 (24%) in group B (p = 0.78). There was no difference in LO between the groups in any type of operation. LOS was shorter in patients in group A who underwent OP: 7.1 (3–17) days versus 8.7 (4–22) days in group B (p <0.0001), and LAP: 5.3 (2–19) days versus 6.4 (2–34) days in group B (p = 0.01). In both groups LOS in the LAP group was significantly shorter than in OP group. There were no significant differences in major complications or mortality between the two groups; however, the complication rates in the OP groups were significantly higher than in LAP and CON combined (p = 0.003).

Conclusions

Elderly patients who undergo LAP have a significantly shorter LOS and fewer complications compared to elderly patients who undergo OP. Laparoscopy should be considered in all patients in whom ileo-colic or sigmoid resection is planned regardless of age.

Keywords

ElderlyLaparoscopyColorectal surgery

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • B. Person
    • 1
  • S. M. Cera
    • 1
  • D. R. Sands
    • 1
  • E. G. Weiss
    • 1
  • A. M. Vernava
    • 1
  • J. J. Nogueras
    • 1
  • S. D. Wexner
    • 1
  1. 1.Department of Colorectal SurgeryCleveland Clinic FloridaWestonUSA