Evaluation of Laparoscopic Colorectal Resection Among Elderly Individuals With Colorectal Malignancy: A Single-center...

Area of Science:

• Geriatric Surgery
• Colorectal Surgery
• Minimally Invasive Surgery

Background:

• Elderly patients undergoing colorectal surgery represent a growing demographic with increased risk of postoperative complications.
• Identifying precise age-related risk thresholds is crucial for optimizing surgical management and patient outcomes.

Purpose of the Study:

• To statistically determine the critical age threshold for increased risk in elderly patients undergoing colorectal surgery.
• To evaluate the safety and efficacy of laparoscopic colorectal resection compared to open surgery in this high-risk elderly population.

Main Methods:

• Retrospective analysis of clinical data from 2015-2019.
• Logistic regression and locally weighted scatterplot smoother analysis to identify risk age and odds ratios (ORs).
• Chow test for structural breakpoint analysis; Student t-test and chi-squared analysis for comparisons.

Main Results:

• Patients aged 69 years or older were identified as a high-risk group for postoperative complications.
• Laparoscopic surgery demonstrated significantly shorter hospital stays, reduced intensive care unit transfers, and lower surgical site infection rates compared to laparotomy.
• Laparoscopic colectomy showed superiority, especially for left-sided resections, with improved overall survival but no difference in disease-free survival.

Conclusions:

• Age 69 serves as a cutoff for increased postoperative morbidity risk in colorectal surgery patients.
• Laparoscopic colorectal resection is a safer and more effective option for elderly patients aged 69+, particularly for left-sided procedures.