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Safety of laparoscopic surgery for colorectal cancer in patients over 80 years old: a propensity score matching study

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Abstract

Purposes

To establish the safety of laparoscopic-assisted colorectal resection for colorectal cancer in elderly patients aged ≥80 years.

Methods

Data were obtained from a chart review of patients who underwent colorectal cancer resection between 2009 and 2014 in Kochi Medical School. The effect of patient age on the extent of lymph node dissection and operative safety was assessed by comparing the short-term results of elderly patients with those of younger patients after propensity score matching.

Results

Of a total of 506 patients with colorectal cancer, 398 underwent laparoscopic surgery and 23% of these patients were aged ≥80 years old. The elderly patients tended to have poorer general condition and larger tumors, although no significant differences were found in tumor invasion, lymph node metastasis, or synchronous distant metastasis between the groups. After adjustment for preoperative factors, we noted that the elderly patients tended to undergo less aggressive surgical resection (P = 0.01). Further analysis after including surgical factors for propensity score matching revealed a similar rate of complications in the two groups (24 vs. 25%, respectively; P = 0.85), and similar postoperative death rates and length of postoperative hospital stay.

Conclusion

The findings of the present study demonstrate that laparoscopic surgery for colorectal cancer should not be avoided based on simply the age of the patient.

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Acknowledgements

We thank all the resident doctors who participated in the registration of clinical data.

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Authors and Affiliations

  1. Department of Surgery, Kochi Medical School, Kochi University, Kochi, Japan

    Mai Shiga, Tsutomu Namikawa, Kazune Fujisawa, Keiichiro Yokota & Kazuhiro Hanazaki

  2. Cancer Treatment Center, Kochi Medical School Hospital, Kohasu, Oko-cho, Nankoku, Kochi, 783-8505, Japan

    Hiromichi Maeda, Ken Okamoto & Michiya Kobayashi

  3. Department of Biostatistics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

    Koji Oba

Authors
  1. Mai Shiga
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  2. Hiromichi Maeda
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  3. Koji Oba
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  4. Ken Okamoto
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  5. Tsutomu Namikawa
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  6. Kazune Fujisawa
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  7. Keiichiro Yokota
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  8. Michiya Kobayashi
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  9. Kazuhiro Hanazaki
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Corresponding author

Correspondence to Hiromichi Maeda.

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No financial support was received for this study.

Conflict of interest

All authors declare that there is no conflict of interest related to this study.

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Shiga, M., Maeda, H., Oba, K. et al. Safety of laparoscopic surgery for colorectal cancer in patients over 80 years old: a propensity score matching study. Surg Today 47, 951–958 (2017). https://doi.org/10.1007/s00595-017-1470-5

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  • DOI: https://doi.org/10.1007/s00595-017-1470-5

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