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Is laparoscopic Colorectal Surgery Beneficial for Elderly Patients? A Systematic Review and Meta-Analysis

  • Original Article
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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Elderly patients who undergo major abdominal surgery are potentially at a higher risk of perioperative mortality and postoperative complications. Although laparoscopic surgery has been widely accepted as a less invasive surgical procedure for colorectal diseases, the benefits for elderly patients have not been validated.

Aim

To compare postoperative outcomes and long-term survival between laparoscopic and open colorectal surgery in the elderly population.

Methods

A literature search was electronically performed to identify all studies comparing postoperative outcomes between laparoscopic and open colorectal resections in the elderly population. Primary outcomes were postoperative mortality and complications, and the secondary outcome was long-term survival.

Results

Overall, 30 studies (70,946 patients) met our inclusion criteria. Laparoscopic surgery was significantly associated with a decreased risk of perioperative mortality [odds ratio (OR), 0.55; 95 % confidence interval (CI), 0.45–0.68; P < 0.01] and postoperative complications (OR, 0.55; 95 % CI, 0.48–0.63; P < 0.01) compared with open surgery. There was no significant difference in long-term survival between the two procedures (OR, 0.89; 95 % CI, 0.72–1.07; P = 0.31).

Conclusions

Laparoscopic colorectal surgery in the elderly population has significant advantages in terms of short-term outcomes. Aggressive application of laparoscopic colorectal surgery should be considered for the elderly population.

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Authors and Affiliations

  1. Department of Surgery, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo, 1608582, Japan

    Ryo Seishima, Koji Okabayashi, Hirotoshi Hasegawa, Masashi Tsuruta, Kohei Shigeta, Shimpei Matsui, Toru Yamada & Yuko Kitagawa

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  1. Ryo Seishima
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  2. Koji Okabayashi
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Correspondence to Koji Okabayashi.

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Supplement 1

Funnel plot of overall postopetrative complications (GIF 105 kb)

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Results of meta-regression analysis (GIF 17 kb)

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Seishima, R., Okabayashi, K., Hasegawa, H. et al. Is laparoscopic Colorectal Surgery Beneficial for Elderly Patients? A Systematic Review and Meta-Analysis. J Gastrointest Surg 19, 756–765 (2015). https://doi.org/10.1007/s11605-015-2748-9

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