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Colorectal surgery in octogenarians

H Spivak1, D V Maele, I Friedman

  • 1Department of Surgery, Beth Israel Medical Center, New York, NY, USA.

Journal of the American College of Surgeons
|July 1, 1996
PubMed
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Elective colorectal resection in patients over 80 is a viable option, offering comparable outcomes to younger patients. However, emergent surgeries in this age group carry higher mortality risks.

Area of Science:

  • Geriatric Surgery
  • Colorectal Surgery
  • Surgical Oncology

Background:

  • Elderly patients are often considered high-risk for surgery.
  • Standard surgical approaches are increasingly recommended for this demographic.
  • Previous series reported significantly higher mortality rates in older populations, questioning procedure applicability.

Purpose of the Study:

  • To evaluate the safety and efficacy of colorectal surgery in patients aged 80 and above.
  • To analyze perioperative care, operative outcomes, and survival rates in this elderly cohort.

Main Methods:

  • Retrospective study of 140 patients (≥80 years) undergoing colorectal surgery (1990-1995).
  • Analysis included 123 colon/rectal resections (79% for carcinoma) and 17 diverting colostomies.

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  • Perioperative care, operative results, and survival were assessed.

    • Main Results:

    • Elective colorectal resections (80.5%) had a 3% mortality rate; emergent resections (19.5%) had a 21% mortality rate.
    • Postoperative morbidity was 27%, with an average hospital stay of 13.1 days.
    • One, two, and five-year survival rates after resection were 85%, 72%, and 40% respectively.

    Conclusions:

    • Elective colorectal resection in the elderly is beneficial and indicated for the same reasons as in younger patients.
    • While emergent operations showed poor outcomes, most elderly patients survived and were discharged.
    • The findings support the continued application of elective colorectal surgery in octogenarians.