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Laparoscopic surgery for colorectal cancer in an elderly population with high comorbidity: a single centre experience
Ist Teil von
International journal of colorectal disease, 2022-09, Vol.37 (9), p.1963-1973
Ort / Verlag
Berlin/Heidelberg: Springer Berlin Heidelberg
Erscheinungsjahr
2022
Link zum Volltext
Quelle
SpringerNature Journals
Beschreibungen/Notizen
Purpose
The use of laparoscopic surgery for colorectal cancer in elderly patients with high comorbidity is a controversial subject. This retrospective analysis aims to compare two different age groups with respect to short and long term clinical and oncological outcomes.
Methods
All laparoscopic colorectal resections for cancer performed between February 2011 and October 2017 with curative or palliative intention were evaluated.
Results
Among 128 completed resections, the rate of major complications, length of hospital stays, 30-day mortality, 2-year recurrence rate, and the survival after palliative surgery were comparable between group A (< 75 years;
n
= 76) and B (≥ 75 years;
n
= 52). Patients in group B showed an extraordinarily high proportion of ASA III stage (73.1% vs. A: 35.5%;
p
< 0.01) and, in this context, an increased rate of minor postoperative complications (17.3% vs. A: 6.6%;
p
< 0.05) and lower overall 2 and 5-year survival rates. Within the first 2 years, they died sooner in the event of recurrence (57.1% vs. A: 18.2%;
p
< 0.05), and their survival after rectal resection, especially for low rectal carcinoma, was significantly reduced (58.8% vs. A: 96.7%;
p
< 0.001).
Conclusion
Laparoscopic surgery for colorectal cancer can be strongly advocated for elderly patients even in the face of high comorbidity. Whether very old patients with low rectal carcinoma also benefit from minimally invasive surgery or should undergo alternative therapies would need to be clarified primarily by examining the quality of life.