Effects of age after laparoscopic right colectomy for cancer: Are there any specific outcomes?

Dig Liver Dis. 2017 May;49(5):562-567. doi: 10.1016/j.dld.2016.12.014. Epub 2016 Dec 21.

Abstract

Background: Laparoscopic approach in colorectal surgery has demonstrated to give advantages in terms of postoperative outcomes, particularly in high-risk patients. The aim was to assess the impact of patients' age on the short-term outcomes after laparoscopic right colectomy for cancer.

Methods: From January 2004 to September 2014, all patients who underwent laparoscopic right colectomy for cancer in a single institution were divided into four groups (A: <64 years; B: 65-74 years; C: 75-84 years; D ≥85 years). Risk factors for postoperative complications were determined on multivariable analysis.

Results: Laparoscopic right colectomy was performed in 507 patients, including 171 (33.7%) in A, 168 (33.1%) in B, 131 (25.8) in C and 37 (7.4%) in D. Patients in Group C and Group D had higher ASA score (p<0.0001) and presented more frequently with anaemia (20.6% and 29.7%, p=0.001). Stages III and IV were more frequently encountered in groups C and D. Overall morbidity was 27.5% without any difference in the four groups (24.5%, 29.1%, 7.5% and 18.4% respectively, p=0.58). The rate of minor complications (such as wound infection or postoperative ileus) was higher in Group D compared to other groups (p=0.05). The only independent variable correlated with postoperative morbidity was intraoperative blood transfusion (OR 2.82; CI 95% 1.05-4.59, p<0.0001).

Conclusions: The present series suggests that patient's age did not significantly jeopardize the postoperative outcomes after laparoscopic right colectomy for cancer.

Keywords: Colorectal cancer; Elderly patients; Laparoscopic right colectomy; Postoperative outcomes; Transfusion.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors*
  • Aged
  • Aged, 80 and over
  • Anemia / epidemiology*
  • Blood Transfusion
  • Colectomy / adverse effects*
  • Colonic Neoplasms / surgery*
  • Colorectal Neoplasms / surgery*
  • Female
  • France
  • Humans
  • Ileus / epidemiology
  • Laparoscopy / methods
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Postoperative Complications / epidemiology*
  • Risk Factors
  • Treatment Outcome
  • Young Adult