DIGESTIVE SURGERY 32, 1, 32 - 38 (2015).
Short-Term Outcomes of Laparoscopic Surgery for Colorectal Cancer in Oldest-Old Patients
Tetsuro Tominaga , Hiroaki Takeshita , Junichi Arai , Katsunori Takagi , Masaki Kunizaki , Kazuo To , Takafumi Abo , Shigekazu Hidaka , Atsushi Nanashima , Takeshi Nagayasu , Terumitsu Sawai
Background/Aims: Oldest-old patients generally have several comorbidities, and laparoscopic-assisted colectonny (LAC) has not been performed on these patients. However, the surgical technique of LAC has improved, and its indications have been extended. The aim of this study was to evaluate the safety and effectiveness of LAC for patients over 85 years old. Methods: Fifty-eight patients over 85 years old who underwent colectomy were retrospectively analyzed. The patients were divided into two groups (LAC group n = 15; open surgery group (Open group) n = 43), and clinicopathological features, surgical characteristics, and outcomes were compared. Results: There were no significant differences in clinical background characteristics between the groups. The LAC group had longer operation time and greater lymph node dissection (both p < 0.01). Postoperatively, the use of analgesics (p = 0.01) was less and the start of oral liquid intake (p = 0.03) was faster in the LAC group. Postoperative complications occurred in 3 patients (20%) in the LAC group and 13 patients (30%) in the Open group (p = 0.66); delirium (n = 6) and sub-ileus (n = 4) developed only in the Open group. Conclusion: After LAC, elderly patients tended to have less postoperative pain and started oral liquid intake earlier. LAC can be safe and effective, preventing postoperative complications that occur specifically in oldest-old patients. (C) 2015 S. Karger AG, Basel