Aim: Minimally invasive surgery for colorectal cancer is increasing globally. However, the safety in older patients have not been thoroughly examined.
Methods: Patients with colorectal cancer who underwent laparoscopic or robot-assisted surgery at Kyoto University Hospital and 18 affiliated institutions in Japan that participated in the Kyoto Colorectal Surgery Group between 2018 and 2023 were enrolled. Focusing on patients ≥80 y, we investigated the risk factors for postoperative complications.
Results: In total, 7303 patients were enrolled in this study. The mean age was 71 ± 11 y, with 1665 patients (22.8%) ≥80 y old. Older patients (≥80 y) had significantly higher ASA and ECOG-PS scores and more comorbidities including diabetes, chronic obstructive pulmonary disease (COPD), hypertension, heart disease, and cerebrovascular disease than patients ≤79 y old (all < 0.05). In the older group, postoperative complications (Clavien-Dindo grade ≥II) occurred in 210 patients (12.6%). After adjusting for covariates using the multivariable logistic regression model, rectal cancer (odds ratio [OR]: 1.84, 95% confidence interval [CI]: 1.30-2.60, = 0.001), operation time ≥300 min (OR: 1.52, 95% CI: 1.07-2.16, = 0.020), and blood loss ≥100 mL (OR: 2.19, 95% CI: 1.80-3.24, < 0.001) were associated with the occurrence of complications, whereas their comorbidities showed no association.
Conclusion: In minimally invasive colorectal cancer surgery for older patients (≥80 y old), prioritizing shorter operation time and blood loss control is crucial, especially for patients with rectal cancer because of their high risk of complications.
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| http://dx.doi.org/10.1002/ags3.12874 | DOI Listing |
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