Techniques in Coloproctology

, Volume 14, Issue 4, pp 323–327 | Cite as

Laparoscopic resection of colorectal cancer: matched comparison in elderly and younger patients

  • V. FisconEmail author
  • G. Portale
  • F. Frigo
  • G. Migliorini
Original Article



Several studies have addressed the issue of the feasibility of laparoscopic colorectal surgery in elderly patients, usually by choosing an arbitrary cut-off age limit, and retrospectively evaluating patient outcomes. The aim of this study was to assess the effects of age on the outcome of laparoscopic colorectal surgery for cancer in a single department, by comparing younger and older patients, matched by ASA score and type of operation.


The perioperative outcome of patients ≥75 years old who underwent laparoscopic colorectal surgery for cancer between June 2005 and January 2009 were compared with findings in younger patients, matched by ASA score and type of operation.


The study included 100 patients, fifty <75 years old (Group A) and fifty ≥75 (Group B) years old. There were 18 right hemicolectomies, 16 left hemicolectomies, 4 anterior resections, 9 low anterior resections, 2 Miles’ operations and 1 segmental resection in each group. We observed a significantly higher overall morbidity rate among elderly patients than among younger patients (24 vs. 8%).


Short-term results after laparoscopic colorectal surgery for cancer in patients ≥75 years old reveal that they have higher postoperative risk compared to their younger counterparts, even when matched by ASA score and type of operation. It suggests that although advanced age, per se, is not a contraindication, it is a risk for patients who undergo laparoscopic colorectal surgery for cancer. This surgery in elderly patients should be performed by experienced surgeons in specialized centers to keep postoperative risk to a minimum.


Colorectal cancer Laparoscopic colon resection ASA score Morbidity Mortality 


  1. 1.
    Lacy AM, Garcìa-Valdecasas LC, Delgado S et al (2002) Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomized trial. Lancet 359:2224–2229CrossRefPubMedGoogle Scholar
  2. 2.
    Milsom JW, Bohm B, Hammerhofer KA, Fazio V, Steiger E, Elson P (1998) A prospective randomized trial comparing laparoscopic versus conventional techniques in colorectal cancer surgery: a preliminary report. J Am Coll Surg 187:146–154CrossRefGoogle Scholar
  3. 3.
    Kwok SP, Lau WY, Carey PD, Kelly SB, Leung KL, Li AK (1996) Prospective evaluation of laparoscopic-assisted large bowel excision for cancer. Ann Surg 223:170–176CrossRefPubMedGoogle Scholar
  4. 4.
    Wexner SD, Cohen SM, Johansen OB, Nogueras JJ, Jagelman DG (1993) Laparoscopic colorectal surgery. A prospective assessment and current perspective. Br J Surg 80:1602–1605CrossRefPubMedGoogle Scholar
  5. 5.
    Seshadri PA, Mamazza J, Schlachta CM, Cadeddu MO, Poulin EC (2001) Laparoscopic colorectal resection in octogenarians. Surg Endosc 15:802–805CrossRefPubMedGoogle Scholar
  6. 6.
    Stocchi L, Nelson H, Young-Fadok TM, Larson DR, Ilstrup DM (2000) Safety and advantages of laparoscopic vs. open colectomy in the elderly: matched-control study. Dis Colon Rectum 43:326–332CrossRefPubMedGoogle Scholar
  7. 7.
    Delgado S, Lacy AM, Garcìa-Valdecasas JC et al (2000) Could age be an indication for laparoscopic colectomy in colorectal cancer? Surg Endosc 14:22–26CrossRefPubMedGoogle Scholar
  8. 8.
    Vignali A, Di Palo S, Tamburini A, Radaelli G, Orsenigo E, Staudacher C (2005) Laparoscopic vs. open colectomies in octogenarians: a case-matched control study. Dis Colon Rectum 48:2070–2075CrossRefPubMedGoogle Scholar
  9. 9.
    De Santis L, Frigo F (2005) Laparoscopic colorectal surgery in the elderly. Acta Biomed 76:S24–S26Google Scholar
  10. 10.
    Scheidbach H, Schneider C, Hugel O, Yildrim C, Lippert H, Kockerling F (2005) Laparoscopic surgery in the old patient: do indications and outcome differ? Langenbecks Arch Surg 390:328–332CrossRefPubMedGoogle Scholar
  11. 11.
    Yamamoto S, Watanabe M, Hasegawa H, Baba H, Kitajima M (2003) Short-term surgical outcome of laparoscopic colonic surgery in octogenarians: a matched case-control study. Surg Laparosc Endosc Percutan Tech 13:95–100CrossRefPubMedGoogle Scholar
  12. 12.
    Sklow B, Read T, Birnbaum E, Fry R, Fleshman J (2003) Age and type of procedure influence the choice of patients for laparoscopic colectomy. Surg Endosc 17:923–929CrossRefPubMedGoogle Scholar
  13. 13.
    Cheung HY, Chung CC, Fung JT, Wong JC, Yau KK, Li MK (2007) Laparoscopic resection for colorectal cancer in octogenarians: results in a decade. Dis Colon Rectum 50:1905–1910CrossRefPubMedGoogle Scholar
  14. 14.
    Colorectal Cancer Collaborative Group (2000) Surgery for colorectal cancer in elderly patients: a systematic review. Lancet 356:968–974CrossRefGoogle Scholar
  15. 15.
    Hoekstra HJ (2001) Cancer surgery in the elderly. Eur J Cancer 37:S235–S244CrossRefPubMedGoogle Scholar
  16. 16.
    Nascimbeni R, Di Fabio F, Di Betta E, Salerni B (2009) The changing impact of age on colorectal cancer surgery: a trend analysis. Colorectal Dis 11:13–18CrossRefPubMedGoogle Scholar
  17. 17.
    Schwandner O, Schiedeck TH, Bruch HP (1999) Advanced age: indication or contraindication for laparoscopic colorectal surgery? Dis Colon Rectum 42:356–362CrossRefPubMedGoogle Scholar
  18. 18.
    Charlson ME, Pompei P, Ales KL, MacKenzie CR (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chron Dis 40:373–383CrossRefPubMedGoogle Scholar
  19. 19.
    Crea N, Di Fabio F, Pata G, Nascimbeni R (2009) APACHE II, POSSUM, and ASA scores in the risk of perioperative complications in patients with colorectal disease. Ann Ital Chir 80:177–181PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • V. Fiscon
    • 1
    Email author
  • G. Portale
    • 1
  • F. Frigo
    • 1
  • G. Migliorini
    • 1
  1. 1.Department of General SurgeryAzienda ULSS 15 ‘Alta Padovana’CittadellaItaly

Personalised recommendations