Laparoscopic colorectal surgery: Is it beneficial in the over 80s?

Advanced age is often associated with higher incidence of co-morbidities, advanced cancer and post-operative complications. The aim of this study was to compare the differences in pre-operative, co-morbidities, cancer stage and surgical outcome measures between patients over the age of 80 and those below 80 undergoing elective laparoscopic colorectal resection.

Data were analysed from a prospectively maintained database between February 2011 and June 2012 and patients were subdivided into two groups (over 80 and under 80). All patients underwent laparoscopic colorectal surgery. Their length of stay, high dependency unit/intensive therapy unit stay, American Society of Anaesthesiologists grade, co-morbidities, conversion rates, Dukes' stage and post-operative complication rates were compared.

Of the 67 patients in the study, 57 were <80 at the time of surgery. Their American Society of Anaesthesiologists grade prior to surgery, as expected, was better than that of the >80 group, with 23% having an American Society of Anaesthesiologists grade of 3 compared to 60% in the >80%. The prognosis of the patients in the two groups based on Dukes' stage was similar, with 63% of the <80 s having a good prognosis, compared to 80% in the >80 s. (Good prognosis = Dukes' A or B). The conversion rates were similar (26% of the <80 s compared to 20% of the > 80 s) Post-operative length of stay was also similar in both groups (<80 s vs. >80 s: median 5 vs. 5; p = 0.33). Post-operative complication rates were similar (17% of the <80 s vs. 20% of the >80 s).

The short-term outcomes following laparoscopic colorectal surgery in the elderly are similar to that of younger patients. Laparoscopic surgery should therefore be offered to all patients irrespective of age.