Abstract
Introduction
The laparoscopic approach is increasingly adopted in colorectal cancer surgery; however, its role in elderly patients is controversial. We sought to examine the relationship between age and short-term outcomes following laparoscopic surgery for colorectal cancer (CRC).
Methods
Data of patients 65 + years old who underwent laparoscopic surgery for CRC between 2002 and 2014 were retrieved from the administrative National Italian Hospital Discharge Dataset. Patients were divided into three age categories (65–74, 75–84, and 85 +). The impact of age on length of stay, 30-day readmission, in-hospital mortality, and postoperative complications was evaluated.
Results
During the study period, 47,704 patients underwent laparoscopic surgery for CRC. The median postoperative length of stay was 9 days, and 30-day readmission and in-hospital mortality were 4.4% and 0.9%, respectively. Age was found to be an independent risk factor of prolonged length of stay and increased in-hospital mortality. With respect to patients in 65–74 years age category, patients aged 75–84 years and those aged 85 + years had a higher risk of complications (OR 1.43, 95% CI 1.36–1.50, and OR 2.00, 95% CI 1.83–2.17, respectively). However, no statistically significant association was found between age and anastomotic leakage or surgical site infection (p = 0.29, and p = 0.58, respectively).
Conclusions
In patients with CRC who underwent laparoscopic surgery, age was found to be an independent risk factor for prolonged length of stay, in-hospital mortality, and global postoperative complications. These findings should be considered when planning laparoscopic surgery in elderly patients.
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Authors acknowledge Mariasole Bigon for her help in this project and the support to the research group.
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Barina Andrea, Nardelli Marco, Gennaro Nicola, Corti Maria Chiara, Marchegiani Francesco, Basso Cristina, Ferroni Eliana, Fedeli Ugo, Spolverato Gaya, and Pucciarelli Salvatore have no conflicts of interest or financial ties to disclose.
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Barina, A., Nardelli, M., Gennaro, N. et al. Impact of laparoscopic approach on the short-term outcomes of elderly patients with colorectal cancer: a nationwide Italian experience. Surg Endosc 34, 4305–4314 (2020). https://doi.org/10.1007/s00464-019-07197-9
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DOI: https://doi.org/10.1007/s00464-019-07197-9