[Postoperative morbidity and mortality factors after laparoscopic resection for colon cancer in octogenarians]

Given the increase in the diagnosis in colon cancer and the access to treatment in patients over 80 years old, our aim is to assess whether laparoscopic surgery still has the demonstrated advantages in post-operative recovery, as well as to analyse the factors that may influence these results.

A retrospective analysis was made on a total of 593 patients subjected to elective laparoscopy surgery due to cancer of the colon between January 1999 and December 2010. They were divided into three age groups: A) less than 70 years (n = 230), B) 70-79 years (n = 209), C) 80 years or over (n=154). The independent variables were: gender, concomitant diseases, previous abdominal surgery, Karnosfky index, BMI, level of, haemoglobin, proteins and albumin, CEA, and ASA grade, location and stage of tumour. The peri-operative dependent variables were: conversion, operating time and blood loss; and post-operative: local and general complications, need for intensive care, further surgery, hospital stay, and death.

Group C had a higher incidence (P<.001) of arterial hypertension, diabetes mellitus, heart disease, chest disease and grade 3 ASA, as well as lower values for the Karnofsky Index, body mass index (BMI), haemoglobin, albumin and total protein. A higher incidence (P>.001) of general complications (respiratory and urinary), further surgery, admission to intensive care unit, longer hospital stay and death, was also observed in the post-operative period in this group.

Although laparoscopic surgery offers advantages to patients over 80 years-old, this group has a higher risk of complications than the younger population and, as a result, we must take great care in their management.