Outcome of laparoscopic surgery for colon cancer in elderly patients

The aim of this study was to evaluate whether elderly patients with colorectal cancer benefit from laparoscopic colon surgery (LAC) in comparison to open colon surgery (OC).

Patients with colon cancer were divided into four groups; >75 years (CC(>75) ) [LAC(>75) (n=36), OC(>75) (n=15)] and ≤75 years [LAC(≤75) (n=90), OC(≤75) (n=26)]. Differences in postoperative short-term outcomes were analyzed among the age and procedure groups.

Intraoperative blood loss was significantly less in the LAC(>75) group (68 ± 168 ml) than in the OC(>75) group (118 ± 130 ml, P=0.040). The C-reactive protein of patients in the OC(>75) group (5.4 ± 2.2 mg/dl) tended to be less than that of the LAC(>75) group (6.1 ± 2.8 mg/dl, P=0.080) on postoperative day 1. The time to the first passage of flatus was significantly shorter in the LAC(>75) group (2.0 ± 0.7 days) than in the OC(>75) group (2.7 ± 0.8 days, P=0.003). Postoperative hospital stays were also shorter in the LAC(>75) group (14.2 ± 9.4 days) than in the OC(>75) group (18.0 ± 8.3 days, P=0.038). No mortality was registered in the LAC(>75) group, while one patient in the OC(>75) group died during the postoperative course. The rate of postoperative morbidity was similar between the LAC(>75) and OC(>75) groups [13.9% (5/36) versus 20.0% (3/15), P=0.679].

LAC provides some advantages over OC in patients with colon cancer aged >75 years as well as in those aged ≤75 years. LAC can be safely performed in very elderly patients with colon cancer.