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Could age be an indication for laparoscopic colectomy in colorectal cancer?
S Delgado1, A M Lacy, J C García Valdecasas
1Department of Gastrointestinal Surgery, Institute of Digestive Diseases, Hospital Clinic, University of Barcelona, Spain.
Background:
The incidence of colorectal carcinoma increases in the elderly. Regardless of age as an isolated factor, postoperative complications represent the main factor in increasing hospital mortality.
Methods:
The aim of this study was to compare the short-term results (first 30 postoperative days) after laparoscopically assisted colectomy (LAC) and open segmental colectomy (OC) in colorectal carcinoma between two groups of patients, older than 70 and younger than 70 years of age. In the study from November 1993 to June 1998, 255 patients were evaluated to participate.
Results:
Peristalsis, oral intake, and discharge from the hospital occurred earlier in LAC than in OC treated patients, in the two age groups. The mean operative time was significantly longer in the LAC than in the OC patients in the two age groups. No differences were observed in morbidity between LAC and OC in the group younger than 70 years of age. However, the overall morbidity was significantly lower in the LAC group in patients older than 70 years. One patient in the LAC group older than 70 years died.
Conclusion:
These results suggest that laparoscopically assisted colectomy may be particularly indicated in elderly patients.