Abstract
Objectives
This study was designed to evaluate the results of laparoscopic resection for colorectal cancer in octogenarians.
Methods
Patients aged 80 years or older who underwent elective laparoscopic resection for colorectal cancer from July 1, 1996 to June 30, 2006 were recruited for analysis, with the following exceptions: 1) patients who did not give informed consent; 2) unfit for operative treatment; 3) presented as surgical emergencies; 4) multiple previous abdominal operations; or 5) locally advanced tumors. Operating time, blood loss, length of hospital stay, mortality and morbidities, including anastomotic dehiscence, pulmonary and wound sepsis, disease recurrence, and patient survival were used to measure outcome.
Results
During a ten-year period, laparoscopic colorectal cancer resection was attempted in 101 octogenarians. The median age was 83 (range, 80-5) years and 45 patients were males. The median operating time was 110 (range, 60-45) minutes, with a median blood loss of 50 (range, 0-,000) ml. Conversion was required in only one case with a leakage rate of 3.3 percent. The overall morbidity and operative mortality rate were 17 and 3 percent, respectively. With a median follow-up of 24 (range, 0-02) months, 22 patients developed recurrence, with 8 of those still surviving. The overall five-year survival is 51 percent.
Conclusions
Our experience confirms that laparoscopic colorectal cancer resection in selected octogenarians is safe and feasible. Aside from the obvious short-term benefits, the long-term oncologic outcomes are favorable.
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References
Redwine DB, Sharpe DR. Laparoscopic segmental resection of the sigmoid colon for endometriosis. J Laparoendosc Surg 1991;1:217-0.
Schlinkert RT. Laparoscopic-assisted hemicolectomy. Dis Colon Rectum 1991;34:1030-.
Chung CC, Tsang WC, Kwok SY, Li KW. Laparoscopy and its current role in the management of colorectal disease. Colorectal Disease 2003;5:528-3.
Milsom JW, Bohm B, Hammerhofer KA, Fazio V, Steiger E, Elson P. A prospective randomized trial comparing laparoscopic versus conventional techniques in colorectal cancer surgery: a preliminary report. J Am Coll Surg 1998;187:46–54.
Lacy AM, García-Valdecasas JC, Delgado S, et al. Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial. Lancet 2002;359:2224-.
Kwok PY, Lau WY, Carey PD, Kelley SB, Leung KL, Li KC. Prospective evaluation of laparoscopic-assisted large bowel excision for cancer. Ann Surg 1996;223:170-.
Wexner SD, Cohen SM, Johansen OB, Nogueras JJ, Jagleman DG. Laparoscopic colorectal surgery. A prospective assessment and current perspective. Br J Surg 1993;80:1602-.
Santoro E, Carlini M, Carboni F, Feroce A. Colorectal carcinoma; laparoscopic versus traditional open surgery. A clinical trial. Hepatogastroenterology 1999;13:595-.
Leung KL, Kwok PY, Lam CW, et al. Laparoscopic resection of rectosigmoid carcinoma: prospective randomised trial. Lancet 2004;363:1187-3.
Nelson H, Sargent DJ, Wieand HS, et al. A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med 2004;350:2050-.
Annual Report 2003. Department of Health: Hong Kong, SAR
Weber DM. Laparoscopic surgery: an excellent approach in elderly patients. Arch Surg 2003:138:1083-.
Isbister WH. Colorectal surgery in the elderly: an audit of surgery in octogenarians. ANZ J Surg 1997;67:557-1.
Fielding LP, Philips RK, Hittinger R. Factors influencing mortality after curative resection for large bowel cancer in elderly patients. Lancet 1989;1:595-.
Payne JE, Chapuis PH, Pheils MT. Surgery for large bowel cancer in people aged 75 years and older. Dis Colon Rectum 1986;29:733-.
Puig-La Calle J Jr, Quayle J, Thaler HT, et al. Favorable short-term and long-term outcome after elective radical rectal cancer resection in patients 75 years of age or older. Dis. Colon Rectum 2000;43:1704-.
Stewart BT, Stitz RW, Lumley JW. Laparoscopically assisted colorectal surgery in the elderly. Br J Surg 1999;86:938-1.
Stocchi L, Nelson H, Young-Fadok TM, Larson DR, Ilstrup DM. Safety and advantages of laparoscopic vs. open colectomy in the elderly: matched-control study. Dis Colon Rectum 2000;43:326-2.
Law WL, Chu KW, Tung PH. Laparoscopic colorectal resection: a safe option for elderly patients. J Am Coll Surg 2002;195:768-3.
Vignali A, Di Palo S, Tamburini A, Radaelli G, Orsenigo E, Staudacher C. Laparoscopic vs. open colectomies in octogenarians: a case-matched control study. Dis Colon Rectum 2005;48:2070-.
Scheidbach H, Schneider C, Hugel O, et al. Laparoscopic surgery in the old patient: do indications and outcomes differ?. Langenbecks Arch Surg 2005;390:328-2.
Slow B, Read T, Birnbaum E, Fry R, Fleshman J. Age and type of procedure influence the choice of patients for laparoscopic colectomy. Surg Endosc 2003;17:923-.
De Santis L, Frigo F. Laparoscopic colorectal surgery in the elderly. Acta Bio-Medica de I Ateneo Parmense 2006;76:24-.
Tuech JJ, Pessaux P, Rouge C, et al. Laparoscopic vs. open colectomy for sigmoid diverticulitis: a prospective comparative study in the elderly. Surg Endosc 2000;14:1031-.
Delgado, Lacy S, Garcia Valdecasas JC, et al. Could age be an indication for laparoscopic colectomy in colorectal cancer?. Surg Endosc 2000;14:22-.
Iroatulam, Chen AJ, Potenti HH, et al. Laparoscopic colectomy yields similar morbidity and disability regardless of patient age. Int J Colorectal Dis 1999;14:155-.
Lewis AA, Khoury GA. Resection for colorectal cancer in the very old: are the risks too high?. BMJ 1988;296:459-1.
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Cheung, H.Y.S., Chung, C.C., Fung, J.T.K. et al. Laparoscopic Resection for Colorectal Cancer in Octogenarians: Results in a Decade. Dis Colon Rectum 50, 1905–1910 (2007). https://doi.org/10.1007/s10350-007-9070-x
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DOI: https://doi.org/10.1007/s10350-007-9070-x