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Laparoscopic surgery for colorectal cancer in an elderly population with high comorbidity: a single centre experience

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

The use of laparoscopic surgery for colorectal cancer in elderly patients with high comorbidity is a controversial subject. This retrospective analysis aims to compare two different age groups with respect to short and long term clinical and oncological outcomes.

Methods

All laparoscopic colorectal resections for cancer performed between February 2011 and October 2017 with curative or palliative intention were evaluated.

Results

Among 128 completed resections, the rate of major complications, length of hospital stays, 30-day mortality, 2-year recurrence rate, and the survival after palliative surgery were comparable between group A (< 75 years; n = 76) and B (≥ 75 years; n = 52). Patients in group B showed an extraordinarily high proportion of ASA III stage (73.1% vs. A: 35.5%; p < 0.01) and, in this context, an increased rate of minor postoperative complications (17.3% vs. A: 6.6%; p < 0.05) and lower overall 2 and 5-year survival rates. Within the first 2 years, they died sooner in the event of recurrence (57.1% vs. A: 18.2%; p < 0.05), and their survival after rectal resection, especially for low rectal carcinoma, was significantly reduced (58.8% vs. A: 96.7%; p < 0.001).

Conclusion

Laparoscopic surgery for colorectal cancer can be strongly advocated for elderly patients even in the face of high comorbidity. Whether very old patients with low rectal carcinoma also benefit from minimally invasive surgery or should undergo alternative therapies would need to be clarified primarily by examining the quality of life.

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Availability of data and materials

Data and material are available at gerald.drews@klinikum-dessau.de.

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Authors and Affiliations

  1. Department of General, Visceral and Thoracic Surgery, Municipal Hospital Dessau, Städtisches Klinikum Dessau, and Brandenburg Medical School Theodor Fontane, Auenweg 38, 06847, Dessau, Germany

    Gerald Drews & Peter Würl

  2. Oncological Outpatient Department, Kastanienhof 1, 06847, Dessau, Germany

    Beatrix Bohnsteen

  3. Institute of Pathology, Martha-Maria Hospital Halle-Dölau, Röntgenstraße 1, 06120, Halle (Saale), Germany

    Jürgen Knolle

  4. Institute of Pathology, University Hospital, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Germany

    Elise Gradhand

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  1. Gerald Drews
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Contributions

Study concept and design: Drews G. Acquisition of data: Drews G, Bohnsteen B, Knolle J, Gradhand E. Analysis and interpretation of data: Drews G, Würl P. Drafting of manuscript: Drews G, Würl P. Critical revision of manuscript: Drews G, Würl P, Gradhand E. The authors read and approved the final manuscript.

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Correspondence to Gerald Drews.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Communicated by H. Babaie.

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Drews, G., Bohnsteen, B., Knolle, J. et al. Laparoscopic surgery for colorectal cancer in an elderly population with high comorbidity: a single centre experience. Int J Colorectal Dis 37, 1963–1973 (2022). https://doi.org/10.1007/s00384-022-04229-0

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