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Laparoscopic colorectal resection versus open colorectal resection in octogenarians: a systematic review and meta-analysis of safety and efficacy

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Abstract

Octogenarians are more often viewed as high-risk surgical candidates. This increased risk is attributed to an age-related decline in physical function and reserve capacity coupled with the presence of various underlying diseases. There are no current guidelines or consensus on the optimal treatment strategy for this cohort of complex patients. The aim of this systematic review and meta-analysis was to compare the efficacy and safety of laparoscopic colorectal resection versus open colorectal resection in octogenarians. The meta-analysis was conducted following all aspects of the Cochrane Handbook for Systematic Reviews and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A systematic literature review was carried out using the following databases: MEDLINE, Embase, PubMed, the Cochrane Library, Google Scholar and OVID. Only studies comparing outcome of laparoscopic and open colorectal resections in the elderly population (≥80 years) were selected. The data collected included the patient demographics, interventions, observed outcome and sources of bias. When performing the statistical analysis, we used the odds ratio for categorical variables and the weighted mean difference for continuous variables. The results of this systematic review and pooled analysis demonstrated the safety and potential benefits of laparoscopic colorectal resection in octogenarians. LC can reduce the length of hospital stay, intraoperative blood loss, time to return of normal bowel function, and incidence of postoperative pneumonia, wound infection, and postoperative ileus.

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Acknowledgments

The present study was supported by grants from the Development Center for Medical Science and Technology, Ministry of Health, PR China (No. W2013R02) and Shanxi Cancer Hospital and Institute (No. 201102).

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    Authors and Affiliations

    1. Department of Colorectal Surgery, The Affiliated Cancer Hospital of Shanxi Medical University, Shanxi Cancer Hospital and Institute, Taiyuan, Shanxi, China

      Y. Li & S. Gao

    2. The Affiliated Cancer Hospital of Shanxi Medical University, Shanxi Medical University, No. 56 Xinjian Road South, Taiyuan, Shanxi, 030001, China

      S. Wang & C. Yang

    3. Department of Gastroenterology, The Affiliated Cancer Hospital of Shanxi Medical University, Shanxi Cancer Hospital and Institute, Taiyuan, Shanxi, China

      W. Yang

    4. Department of Molecular Biology, The Affiliated Cancer Hospital of Shanxi Medical University, Shanxi Cancer Hospital and Institute, Taiyuan, Shanxi, China

      S. Guo

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    1. Y. Li
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    Correspondence to Y. Li.

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    All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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    Y. Li and S. Wang have contributed equally to this work.

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    Li, Y., Wang, S., Gao, S. et al. Laparoscopic colorectal resection versus open colorectal resection in octogenarians: a systematic review and meta-analysis of safety and efficacy. Tech Coloproctol 20, 153–162 (2016). https://doi.org/10.1007/s10151-015-1419-x

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    • DOI: https://doi.org/10.1007/s10151-015-1419-x

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