Colorectal resection in nonagenarians: effectiveness of laparoscopic surgery

Asian J Endosc Surg. 2014 Aug;7(3):222-6. doi: 10.1111/ases.12105. Epub 2014 Apr 15.

Abstract

Introduction: The number and proportion of elderly persons in the general population have been increasing. Inevitably, the incidence of colorectal carcinoma has also increased. Although substantial evidence indicates that surgery is well tolerated in patients 80 years or older, studies in nonagenarians are not well documented.

Methods: Consecutive nonagenarians and octogenarians who underwent elective laparoscopic-assisted colectomy (LAC) from September 2009 through October 2011 were studied. Data on medical history, ASA score, details of operations, and postoperative events were collected.

Results: LAC was performed in nine nonagenarians and seven octogenarians. There were no complications related to laparoscopy. No patient required conversion from LAC to an open procedure or died postoperatively. Peristalsis was confirmed and oral intake was initiated on postoperative days 2.6 and 2.7, respectively.

Conclusions: Laparoscopic surgery is considered an extremely useful treatment for very old patients because it has a low risk of postoperative complications, even in the presence of pre-existing diseases. We conclude that LAC may be indicated in nonagenarians.

Keywords: Colorectal cancer; laparoscopic surgery; nonagenarian.

MeSH terms

  • Age Factors
  • Aged, 80 and over
  • Carcinoma / pathology
  • Carcinoma / surgery*
  • Cohort Studies
  • Colectomy
  • Colonic Neoplasms / pathology
  • Colonic Neoplasms / surgery*
  • Female
  • Humans
  • Laparoscopy*
  • Male
  • Operative Time
  • Treatment Outcome