Outcomes of laparoscopic surgery for colorectal cancer in elderly patients.

Objective: To evaluate the short-term outcomes of laparoscopic colorectal surgery for cancer in the elderly compared with younger patients.

Methods: We retrospectively considered a consecutive unselected series of 159 patients who underwent elective laparoscopic procedures for colorectal cancer at our institution between January 2007 and December 2009. Of these patients, 101 (63.5%) were ≤ 70 years of age (Group A), and 58 (36.5%) were >70 (Group B). Operative steps and instrumentation were standardized. Demographics, disease-related, operative, and short-term data were analyzed for each group, and an appropriate statistical comparison was made. Comorbidity was quantified by using the Charlson Comorbidity Index.

Results: We reviewed right colectomies (29.5%), left colectomies (44.7%), rectal resections (19.5%), and other procedures (6.3%). There was no significant difference in sex ratio, body mass index, American Society of Anesthesiology score, type of surgical procedures, and tumor stage between Group A and Group B. A statistically higher comorbidity according to the Charlson index characterized Group B (2.2 vs 3.8; P=.034). Median operative time (228 ± 78.1min vs 224.3 ± 97.6min; NS), estimated blood loss (50.0 ± 94.8mL vs 31.2 ± 72.7mL; NS), conversion rate (2.0% vs 1.7%; NS), and timing to canalization (4.5 ± 1.7dd vs 4.4 ± 1.3dd; NS) were statistically comparable in both Groups. Group B was associated with a significantly longer length of hospital stay compared with Group A (8.1 ± 2.8dd vs 10.8 ± 6.6dd; P<.01) There was no statistically significant difference in major postoperative complications (3.8% vs 3.4%; NS), reoperations (0.9% vs 1.7%; NS), and 30-day mortality (0% vs 1.7%; NS).

Conclusions: Laparoscopic colorectal surgery appears feasible and safe in elderly patients with increased comorbidity.