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Laparoscopic colorectal resection in octogenarians.

P A Seshadri¹, J Mamazza, C M Schlachta

¹The University of Toronto Center for Minimally Invasive Surgery, St. Michael's Hospital, Wellesly Central Site, 160 Wellesley Street E, Jones Building #218, Toronto, Ontario, M4Y 1J3, Canada.

Surgical Endoscopy

|July 10, 2001

Summary

Laparoscopic colorectal resection is safe and feasible for octogenarians, showing improved outcomes compared to open surgery. This minimally invasive approach offers potential benefits for elderly patients requiring colorectal procedures.

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Area of Science:

Geriatric Surgery
Minimally Invasive Surgery
Colorectal Surgery

Background:

The aging population is increasing, with a higher proportion of patients over 80 years old requiring surgical intervention.
Elderly patients often experience elevated morbidity and mortality rates following surgery.
Surgical outcomes for laparoscopic colorectal resection in octogenarians are not extensively documented.

Purpose of the Study:

To evaluate the safety and efficacy of laparoscopic colorectal resection in patients aged 80 years and older.
To analyze the preoperative comorbidities and surgical outcomes in this specific patient demographic.

Main Methods:

Identification of octogenarian patients (aged 80+) from a prospective database of 507 laparoscopic colorectal resections.

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Analysis of preoperative comorbidity data and intraoperative and postoperative surgical outcomes.

Comparison of outcomes with historical controls of open colorectal resection in octogenarians.

Main Results:

Sixty-two octogenarians underwent laparoscopic colorectal resection; 7% required conversion to open surgery.
The overall 30-day mortality rate was 5%.
Postoperative complications occurred in 31% of patients, with a median hospital stay of 10 days for uncomplicated cases.

Conclusions:

Laparoscopic colorectal resection is technically feasible and safe for octogenarian patients.
Outcomes demonstrate superiority over historical open surgery controls, with reduced mortality and fewer complications.
Further randomized trials are needed to definitively establish the advantages of laparoscopic over open colorectal resection in the elderly.