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The Impact of the Risk Factor “Age” on the Early Postoperative Results of Surgery for Colorectal Carcinoma and Its Significance for Perioperative Management

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Abstract

The risks and benefits of surgery for colorectal cancer in old patients have not been unequivocally defined. The present investigation was carried out in 309 hospitals as a prospective multicenter study. In the period between 1 January 2000 and 31 December 2001, a total of 19,080 patients were recruited for the study; 16,142 (84.6%) patients were younger than 80 years (<80) and 2932 (15.4%) were 80 years and older (≥ 80). Significant differences between the age groups were observed for general postoperative complications (22.3% for <80 years; 33.9% for ≥ 80). Specific postoperative complications were identical in both groups. Overall, significantly elevated morbidity and mortality rates were found with increasing age (morbidity: 33.9% vs. 43.5%; mortality: 2.6% vs. 8.0%). The distribution of tumor stages revealed a significantly higher percentage of locally advanced tumors in the older age group (stage II: 28.0% vs. 34.4%). In contrast, no increase in metastasizing tumors was found in the older age group (stage IV: 17.4% vs. 14.1%). Logistic regression showed that, in concert with a number of other parameters, age is a significant influencing factor on postoperative morbidity and mortality. The increase in postoperative morbidity and mortality rates associated with aging is a result of the increase in general postoperative complications, in particular, pneumonia and cardiovascular complications. Age as such does not represent a contraindication for surgical treatment. The short-term outcome and quality of life are of overriding importance for the geriatric patient.

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Author information

Authors and Affiliations

  1. Institute for Quality Management in Operative Medicine, Otto-von-Guericke University Magdeburg, Leipziger Str. 44, Magdeburg, D-39120, Germany

    Frank Marusch M.D., Ph.D., Andreas Koch M.D., Uwe Schmidt, Ralf Steinert M.D., Torsten Ueberrueck M.D., Ferdinand Köckerling M.D., Ph.D., Ingo Gastinger M.D., Ph.D. & Hans Lippert M.D., Ph.D. (the Working Group “Colon/Rectum Cancer” (WGCRC)

  2. Department of Surgery, Marien-Hospital Stuttgart, Boeheimstr. 37, Stuttgart, D-70199, Germany

    Reinhard Bittner M.D., Ph.D.

  3. Department of Coloproctology, Prosper-Hospital Recklinghausen, Muehlenstr. 27, Recklinghausen, D-45659, Germany

    Eugen Berg M.D.

  4. Department of Surgery, Aschaffenburg Hospital, Am Hasenkopf, Aschaffenburg, D-63739, Germany

    Rainer Engemann M.D., Ph.D.

  5. Department of Surgery, Oscar-Ziethen-Hospital, Berlin-Lichtenberg, Fanningerstr. 32, Berlin, D-10365, Germany

    Klaus Gellert M.D., Ph.D.

  6. Department of Surgery, Pforzheim Hospital, Kanzlerstr. 2-6, Pforzheim, D-75175, Germany

    Rainer Arbogast M.D., Ph.D.

  7. Department of Surgery, Hanover-Hospital, Roesebeckstr. 15, Hanover, D-30449, Germany

    Thomas Körner M.D., Ph.D. & Ferdinand Köckerling M.D., Ph.D.

  8. Department of Surgery, Carl-Thiem Hospital Cottbus, Thiemstr. 111, Cottbus, D-03048, Germany

    Frank Marusch M.D., Ph.D., Andreas Koch M.D., Ralf Steinert M.D., Torsten Ueberrueck M.D. & Ingo Gastinger M.D., Ph.D.

  9. Department of Surgery, Otto-von-Guericke University Magdeburg, Leipziger Str. 44, Magdeburg, D-39120, Germany

    Hans Lippert M.D., Ph.D. (the Working Group “Colon/Rectum Cancer” (WGCRC)

Authors
  1. Frank Marusch M.D., Ph.D.
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  2. Andreas Koch M.D.
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  3. Uwe Schmidt
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  4. Ralf Steinert M.D.
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  5. Torsten Ueberrueck M.D.
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  6. Reinhard Bittner M.D., Ph.D.
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  7. Eugen Berg M.D.
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  8. Rainer Engemann M.D., Ph.D.
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  9. Klaus Gellert M.D., Ph.D.
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  10. Rainer Arbogast M.D., Ph.D.
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  11. Thomas Körner M.D., Ph.D.
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  12. Ferdinand Köckerling M.D., Ph.D.
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  13. Ingo Gastinger M.D., Ph.D.
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  14. Hans Lippert M.D., Ph.D.
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Corresponding author

Correspondence to Frank Marusch M.D., Ph.D..

Appendix

Appendix

Working Group “Colon/Rectum Cancer” (WGCRC) (Hospital and Departmental Chairman)

Lukas Hospital Anklam (G. Maskow), Kreiskrankenhaus Arnstadt (D. Rose), HELIOS Klinikum Aue (R. Albrecht), Waldkrankenhaus Obervogtland Adorf(J.-J. Hüttner), Kreiskrankenhaus Altenburg (A. Petzold), Kreiskliniken Aschersleben-Staßfurt (T. Landes), Sankt Josef-Krankenhaus Adenau (M. Kötting), Klinikum Aschaffenburg (R. Engemann), Sankt Nikolaus Stiftshospital Andernach (K. Fischer), Kreiskrankenhaus Altötting (H. Bauer), Sankt Marien-Krankenhaus Ahaus (M. Schimmöller), Marienhospital Aachen (K. Nagel), Klinikum Ansbach (H. Kottsieper), Lukas-Krankenhaus Bünde (T. Emmanouilidis), Hufeland-Krankenhaus Bad Langensalza (L.-D. Schreiber), Kreiskrankenhaus Bad Liebenstein (K. Bauer), HUMAINE Klinikum Bad Saarow (S. Kühn), Kreiskrankenhaus Beeskow (M. Rintisch), Klinikum Berlin-Buch (E. Bärlehner), Krankenhaus im Friedrichshain (J. Straßburg), Oskar-Ziethen-Krankenhaus Berlin (K. Gellert), Unfall-Krankenhaus-Berlin (D. Lorenz), Kreiskrankenhaus Bischofswerda (B. Günther), Westküstenklinik Brunsbüttel (J. Geisthövel), Kreiskrankenhaus Burg (J. Reisig), HELIOS Klinik Borna (B. Irmscher), DRK-Manniske-Krankenhaus gGmbH (G. Hoffmann), Klinik Bad Windsheim (J. Demann), Krankenhaus Berlin Moabit (E. Kraas), Sankt Agnes Hospital Bocholt (T. Berns), Asklepios-Stadt-Klinik Bad Tölz (C. Kiehling), Marienhospital Brühl (K. Jaeger), Sankt Elisabeth Krankenhaus Bad Kissingen (M. Kahle), Sankt Gertrauden Krankenhaus Berlin (K.-H. Fey), Franziskus Hospital Bielefeld (J.O. Jost), DRK-Kliniken Westend Berlin (E. Kraas), Krankenhaus Braunschweig (R. Maüeler), Kreiskrankenhaus Burglengenfeld (H.M. Höhne), Krankenanstalten Gilead Bielefeld (P. Schroeder), Zentralkrankenhaus Bremen (H.H. Wenk), Kreiskrankenhaus Burgwedel (H.-E. van Alste), Kreiskrankenhaus Bad Schwalbach (G. Tolksdorff), Krankenhaus am Bürgerpark Bremerhaven (G. Otten), Cusanus-Krankenhaus Bernkastel-Kues (H. Rothschenk), Städtisches Krankenhaus Bad Reichenhall (E. Pratschke), Kreiskrankenhaus Backnang (W. Gruner), Sankt Josef Krankenhaus Berlin (R. Kunz), Kliniken des Main-Taunus-Kreises Bad Soden (P. Wendling), Krankenhaus Sankt Joseph-Stift Bremen, Schloßpark-Klinik Berlin (V. Lange), Krankenhaus Neukölln Berlin (A. Holzgreve), Fürst-Stirum-Klinik Bruchsal (H. Thiele), Evang. Krankenhaus Bad Godesberg Bonn (D. Schröder), Südholstein Kliniken Bad Segeberg (H.-P. Schrenk), Evang. Krankenhaus Bergisch Gladbach (R. Schmitz), Klinikum Coburg (P. Klaue), Stadtkrankenhaus Calbe (Th. Heinrich), Carl-Thiem-Klinikum Cottbus (I. Gastinger), Sankt Rochus-Hospital Castrop-Rauxel (J. Eitemuller), St. Josefs-Hospital Cloppenburg (H. Faust), Sankt Vincenz-Hospital Coesfeld (K. Warnecke) Städtische Kliniken Delmenhorst (W. Dietz), Kreiskrankenhaus Demmin (B. Parnitzke), Kreiskrankenhaus Diepholz (H. Bongartz), Technische Universität Dresden (H.D. Saeger), Städtisches Krankenhaus Dresden (H. Diettrich), Krankenhaus Sankt Joseph-Stift Dresden (J. Voß), Städtische Klinik Dessau (K. Ridwelski), Krankenhaus Dresden Friedrichstadt (K. Ludwig), Florence-Nightingale-Krankenhaus Düsseldorf (K.-H. Schultheis), Klinikum Detmold (W. Hiller), Kreiskrankenhaus Dormagen (D. Moschinski), Ev. Krankenhaus Elisabethenstift Darmstadt (K. Griesenbeck), Evangelisches und Johanniter Klinikum Dinslaken (J. Erhard), Krankenhaus Maria Hilf Daun (A. Kuckartz), Knappschafts-Krankenhaus Dortmund (E. Hanisch), Klinikum Darmstadt (C. Petermann), Kreiskrankenhaus Eichstätt (V. Sänger), Sankt Antonius-Hospital Eschweiler (H.-W. Menges), Kreiskrankenhaus Ebersdorf (G. Singer), Werner-Forßmann-Krankenhaus Eberswalde (B. Goetzke), Christliches Krankenhaus Eisenach (W. Pampuch), Katholisches Krankenhaus “St. J. Nepomuk” Erfurt (Pertschy), Sankt Willibrord-Spital Emmerich (A. Stobernack), Hermann-Josef-Krankenhaus Erkelenz (M. Zander), Alfried Krupp Krankenhaus Essen (M. Betzler), Krankenhaus Erlenbach (U. Schmitz), Marienhospital Emsdetten (A. Schneider), Städtische Kliniken Esslingen (P. Mattes), Kreiskrankenhaus Eggenfelden (L. Schmück), Kreiskrankenhaus Eschwege (D. Schröder), Ev.-luth. Diakonissenkrankenhaus Flensburg (V. Mendel), Kreiskrankenhaus Finsterwalde (P. Schuback), Kreiskrankenhaus Forst (St. Schwanitz), Klinikum Frankfurt/Oder (Hoffmann), Sankt Katharinen-Krankenhaus Frankfurt (U. Finke), St. Marien-KH Katharina Kasper Kliniken Frankfurt (J. Schumann), Bürgerhospital Frankfurt am Main (R. Wahl), Sankt Elisabeth Krankenhaus Frankfurt (C. Hottenrott), Sankt Elisabeth-Krankenhaus Geilenkirchen (G. Haselow), Wald-Klinikum Gera (Th. Manger), Kreiskrankenhaus “Rudolf Virchow” Glauchau (R. Morgenstern), Helios Klinik Gotha (K. Bickel), Ernst-Moritz-Arndt-Universität Greifswald (C.D. Heidecke), Naemi-Wilke-Stift Guben (J. Müller), Kreiskrankenhaus Güstrow (W. Brinkmann), Kreiskrankenhaus Gifhorn (M. Rohr), Städtisches Krankenhaus Gütersloh (M. Varney), Kreiskrankenhaus Grevenbroich (L. Köhler), Dr. Herbert-Nieper-Krankenhaus Goslar (C. Scheele), Marienhospital Gelsenkirchen (H.-M. Kohaus), Franziskus-Hospital Georgsmarienhütte (W. Heidemann), Klinik am Eichert Göppingen (R. Eisele), Kreiskrankenhaus Gelnhausen (T. Zoedler), St. Josef Hospital Gelsenkirchen (H.P. Harasim), Ev. Krankenhaus Hagen (F. Hain), St. Salvador-Krankenhaus Halberstadt (H. Putzki), Diakoniekrankenhaus Halle/Saale (U. Rose), Sankt Elisabeth-Krankenhaus Halle/Saale (W. Asperger), Martin-Luther-Universität Halle/Saale (H. Dralle), Städtisches Krankenhaus Martha-Maria Halle/Saale (Ch. Richter), St. Vincenz-Krankenhaus Heiligenstadt (D. Weilandt), Kreiskrankenhaus Herzberg (Seifert), Henneberg Kliniken Hildburghausen (G. Eigendorf), Krankenhaus Hohenfelde (A. Friedrich), Klinikum Hoyerswerda (E. Simonis), Sankt Anna Hospital Herne (J. Kozianka), Malteser-Krankenhaus Sankt Josef Hamm (H.O. Steiger), Evangelisches Krankenhaus Hamm (W.-E. Krau), Henriettenstiftung Hannover (J. Jähne), Städtisches Krankenhaus Hildesheim (A. Richter), Evangelisches Krankenhaus Holzminden (S.W. Schulz), Sankt Ansgar-Krankenhaus Höxter (H.-D. Reiß), Albertinen-Krankenhaus Hamburg (H. Mondt), Klinikum Nord/Heidberg Hamburg (K. Rückert), Klinikum Hannover-Siloah (F. Köckerling), Ev. Amalie-Sieveking-Krankenhaus Hamburg (P. Matthaei), DRK-Krankenhaus Clementinenhaus Hannover (A. Kuthe), Kreiskrankenhaus Heidenheim (D. Timm), Klinik Dr. Guth Hamburg (R. Wacker), Evang. Diakoniewerk Friederikenstift Hannover (R.-D. Keferstein); Allgemeines Krankenhaus Hamburg-Harburg (H. Imig), Allgemeines Krankenhaus Hamburg-Barmbeck (E. Gross), Evangelisches Krankenhaus Hattingen (H. Waleczek), Allgemeines Krankenhaus Hamburg-Eilbeck (L. Steinmüller), Klinikum Hanau (A. Valesky), Sankt Barbara-Klinik Heesen Hamm (E.-H. Steinmann), Krankenhaus Itzehoe (G. Schürmann), Friedrich-Schiller-Universität Jena (A. Altendorf-Hofmann), Johanniter-Krankenhaus Juterborg (W.-R. Matting), Paracelsusklinik Karlsruhe (K. Futterer), Kreiskrankenhaus Kirchberg (M. Nassar), Marienhospital Kevelaer (F.-J. Peveling-Oberhag), Krankenhaus Porz am Rhein Köln (S. Horsch), St. Marienhospital Köln (H. Heistermann), Evangelisches Krankenhaus Kreuztal-Kredenbach (G. Brand), Krankenhaus Koblenz (K.H. Hoblinger), Klinikum Konstanz (M. Nagel), Klinikum Kempten (M. Neher), Elisabeth-Krankenhaus Kirchen (J. Düber), Sankt Antonius Krankenhaus Köln (E.-A. Cramer), Rotes Kreuz Krankenhaus Kassel (R. Hesterberg), Sankt Vinzenz Hospital Köln (D. Trüb), Städtisches Krankenhaus Köln-Holweide (H.F. Kienzle), Stadtkrankenhaus Korbach (W. Jäger), Frankenwaldklinik Kronach (T. Hager), Klinikum Kulmbach (G. Endsberger), Sankt Josefs Hospital Krefeld (J. Müsgens), Kreiskrankenhaus Lörrach (J. Waninger), Vinzentiuskrankenhaus Landau (K. Werthmann), Klinikum Niederlausitz Lauchhammer (W. Kärgel), Sankt Elisabeth-Krankenhaus Leipzig (J. Steuber), Städtisches Klinikum “St. Georg” Leipzig (A. Weimann), Universität Leipzig (Hauss), Spreewaldklinik Lübben (Ch. Wiesner), Evangelisches Krankenhaus Luckau (W. Pluntke), DRK-Krankenhaus Luckenwalde (U. Fleck), Paul-Gerhardt-Stiftung Wittenberg (H. Zühlke), HELIOS-Krankenhaus Leisnig (M. Jäger), Klinikum Ludwigshafen (K. Schönleben), Asklepios Klinik Lien (P.A. Hild), Klinikum Lahr (G. Mangold), Klinikum Leverkusen (K.-H. Vestweber), Klinikum Lemgo (M. Probst), Kreiskrankenhaus Leer (N. Reijnen), Sankt Elisabeth Krankenhaus Lörrach (B. Vetter), Evangelisches Krankenhaus Lippstadt (M. Mayer), Helmut G. Walter Klinikum Lichtenfels (B. Greger), Dr.-Otto-Geßler-Krankenhaus Lindenberg (U. Mocke), Krankenhaus Lübbecke (U. Werner), Städtisches Krankenhaus Landau (F. Wilhelm), Sankt Marien-Hospital Lünen (G. Görtz), Kliniken Maria Hilf Mönchengladbach (U. Kania), Kreiskrankenhaus Münsingen (T. Jungmann), Otto-von-Guericke-Universität Magdeburg (H. Lippert), Städtisches Klinikum Magdeburg (W. Mokros), Kreiskrankenhaus Meißen (F. Kühn), Unstrut-Hainich-Kreiskrankenhaus Mühlhausen (W. Kneist), Elisabeth-Krankenhaus Rheydt Mönchengladbach (H.D. Jakubowski), Krankenhaus 3. Orden München (E. Pütterich), Sankt Hildegardis Krankenhaus Mainz (K.-D. Höhle), SHG Kliniken Merzig (G. Sinner), Evangelisches Krankenhaus Mülheim an der Ruhr (K. Kipfmüller), Sankt Elisabeth-Krankenhaus Mayen (B. Engelke), Sankt Franziskus-Hospital Münster (U. Schulz), Raphaelsklinik Münster (F. Raulf), Krankenhaus Bethanien Moers (E. Cillis), Evangelisches Krankenhaus “Bethesda” Mönchengladbach (S. Langer), Friedrich-Ebert-Krankenhaus Neumünster (E. Deltz), Krankenhaus Neunkirchen (C. Engel), Klinikum Neubrandenburg (M. Ernst), Ruppiner Klinikum Neuruppin (Th. Buthut), Krankenhaus der Diakonieanstalt “Emmaus” Niesky (W. Georgi), Südharz-Krankenhaus Nordhausen (J. Rupprecht), Lukaskrankenhaus Neuss (P.E. Goretzki), Kreiskrankenhaus Nagold (V. Götze), Klinikum Neustadt (R. Linder), DRK-Krankenhaus Neuwied (T. Riemenschneider), Krankenhaus Neustadt (J. Milker), Grafschafter Klinikum Nordhorn (H.-J. Humberg), Kreiskrankenhaus Norden (R. Brückner), Kreiskrankenhaus Otterndorf (H. Böckenkamp), Brüder-Krankenhaus St. Josef Olsberg (S. Krummbein), Sankt Martinus-Hospital Olpe (H.-J. Meyer), Sankt Elisabeth-Krankenhaus Oberhausen (H.-W. Schlösser), Städtische Kliniken Oldenburg (R. Raab), Sankt Marien-Hospital Osterfeld Oberhausen (F.-J. Schumacher), Klinikum Osnabrück (M. Clemens), Marienkrankenhaus Papenburg (U. Böckmann), Kreiskrankenhaus Pasewalk (R. Benthin), Kreiskrankenhaus Plau am See (T. Schmid), Vogtland-Klinikum Plauen (G.-M. Fleischer), Kreiskrankenhaus Pößneck (W. Hothorn), Klinikum “Ernst v. Bergmann” Potsdam (H.J.C. Wenisch), Krankenhaus Pritzwalk (J. Bohl), Kreiskrankenhaus Rottal-Inn Pfarrkirchen (K. Schäfer), Sankt Johannis-Stift Paderborn (R. Schmidt), Krankenhaus der Bundesknappschaft Püttlingen (G. Simonis), Brüderkrankenhaus Sankt Josef Paderborn (H. Anheier, W. Dee), Städtisches Krankenhaus Pirmasens (G. Adamidis), Städtisches Klinikum Pforzheim (R. Arbogast), Mathias-Spital Rheine (M. Lausen), Kreiskrankenhaus Reichenbach (H.-G. Ehlert), Krankenhaus Riesa Kliniken (R. Zippel), Kreiskrankenhaus Roßlau (L. Heinrich), Klinikum Südstadt Rostock (H.-D. Czarnetzki), Sankt Adolf Stift Reinbek (A. Eggert), Prosperhospital Recklinghausen (E. Berg), Kreiskrankenhaus Riedlingen (R.A. Bader), Kreiskrankenhaus Rheinfelden (K. Walter), Krankenhaus St. Elisabeth Ravensburg (P. Klein), Krankenhaus der Barmherzigen Brüder Regensburg (J. Dobroschke), Kreiskrankenhaus Roth (H. Rogenhofer), Nordwest-Krankenhaus Sande (T. Hau), Thüringen Klinik “Georgius Agricola” Saalfeld/Saale (H. Rupprecht), Klinikum Niederlausitz Senftenberg (Ch. Gatzweiler), Kyffhäuserkreiskrankenhaus Sondershausen (P. Surup), Kreiskrankenhaus Sonneberg (H. Weber), Kreiskrankenhaus Spremberg (G. Auerbeck), Kreiskrankenhaus Salzwedel (C. Luck), Kreiskrankenhaus Sömmerda (U. Bust), Kreiskrankenhaus Sulingen (F. Wilken), Krankenhaus Siegburg (G. Horeyseck), Caritasklinik Sankt Theresia Saarbrücken (S. Frick), Kreiskrankenhaus Siegen (T. Gehrke), Städtisches Krankenhaus Sindelfingen (G. Köveker), Klinikum Saarbrücken (J. Limmer), Diakoniekrankenhaus Schwäbisch Hall (V. Lenner), Kreiskrankenhaus “Bergmannswohl” Schkeuditz (F. Steinert), Kreiskrankenhaus Schmalkalden (V. Bock), Marienhospital Stuttgart (R. Bittner), Klinikum Uckermark Schwedt (R. Koll), Juraklinik Scheßlitz (B. Dietz), Johanniter-Krankenhaus Stendal (M. Knoch), Kreiskrankenhaus Stollberg (W. Hubel), Klinikum Sankt Elisabeth Straubing (H.F.K. Männl), Marienkrankenhaus Sankt Wendel (R. Reinert), Kreiskrankenhaus Stadthagen (C. Hegelmaier), Kreiskrankenhaus Sankt Ingbert (M. Lindemann), Karl Olga Krankenhaus Stuttgart (J. Benz), Robert-Bosch-Krankenhaus Stuttgart (K.P. Thon), Sankt Josef Hospital Troisdorf (R. Dockter), Kreiskrankenhaus Torgau (W. Dudda), Kreiskrankenhaus Tuttlingen (J. Jenker), Elisabeth-Krankenhaus Thuine (K. Grambach), Evangelisches Elisabeth-Krankenhaus Trier (E.A. Smague), Krankenhaus Vilshofen (G. Kohlbacher), Sankt Christophorus-Krankenhaus Werne (E. Wernet), Kreiskrankenhaus Wertingen (W. Streifinger), Müritz Klinikum Waren (G. Siggelkow), Kreiskrankenhaus Weißenfels (J. Brettschneider), Kreiskrankenhaus Weißwasser (H. Grumbt), Kreiskrankenhaus Westerstede (W. Probst), Stadtkrankenhaus Wolfsburg (J. Meyer), Kreiskrankenhaus Wolfratshausen (M. Richter-Tutur), Sankt Josefs-Hospital Wiesbaden (M. Houf), Sankt Franziskus Hospital Winterberg (M. Schwenen), Kreiskrankenhaus Wörth (B. Semsch), Evangelisches Krankenhaus Wesel (E. Nosseir), Marienkrankenhaus Wickede-Wimbern (W. Kamski), Dreifaltigkeitskrankenhaus Wesseling (A. Geuenich), Katharinen-Hospital Willich (E. Hinckel), Sankt Josef-Krankenhaus Zell (N. Schieffer), Kreiskrankenhaus Zeitz (T. Bolle), Kreiskrankenhaus Mittleres Erzgebirge Zschopau (M. Mory), Paracelsus-Klinik Zwickau (J. Renz), Kreiskrankenhaus Anhalt Zerbst (L: Heinrich), St. Elisabeth-KH Zweibrücken (Chr. Metzner)

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Marusch, F., Koch, A., Schmidt, U. et al. The Impact of the Risk Factor “Age” on the Early Postoperative Results of Surgery for Colorectal Carcinoma and Its Significance for Perioperative Management. World J. Surg. 29, 1013–1021 (2005). https://doi.org/10.1007/s00268-005-7711-6

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