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Laparoscopic colectomy for carcinoma of the colon in octogenarians
Nidal Issa1, Chiara Grassi, Yededia Melki
1Surgery Department, Hasharon Hospital, Rabin Medical Center, Petah-Tikva, and the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel. nidalissa@clalit.org.il
Background:
The incidence of colorectal cancer increases with age; most patients present with resectable disease. Since there is a high morbidity rate in the elderly, the laparoscopic approach, with its lower complication rate, appears to be the ideal choice for treatment of this patient group. In this retrospective study, we aimed to compare the short-term results of laparoscopic (LC) with open (OC) colectomies for carcinoma in patients 80 years of age or older.
Methods:
The study comprised 93 patients aged 80 years and over who underwent OC or LC between 2005 and 2008. Demographics and clinical data were compared.
Results:
The LC group included 47, and the OC included 46 patients. No differences were found between the two groups with regard to mean age, comorbidities, and the extent of the resection. The operative time was shorter in the OC (121 vs. 157 min, P = 0.001). Hospital stay was shorter in the LC (7.6 vs. 8.8 days, P = 0.06). There were more postoperative complications in the OC (35.6%) than in the LC (30.4%), however the difference was not statistically significant (P = 0.6).
Conclusions:
LC in the elderly is safe, with a shorter hospital stay, and carries a short-term benefit for selected patients and could be offered to all elderly patients.
