Colorectal surgery in elderly population

Pol Przegl Chir. 2018 Jun 13;90(4):29-34. doi: 10.5604/01.3001.0011.8179.

Abstract

Introduction: With the rising number of elderly patients and increasing incidence of colorectal cancer, management of geriatric patients has become the forefront of colorectal surgery.

Objectives: This study aimed to investigate the short-term surgical outcomes following colorectal resection in elderly patients.

Materials and methods: A total of 464 patients who underwent surgical resection for colorectal tumor between 2013 and 2017 were included. The patients were divided into elderly (≥75 years) and young (<75 years) group. The clinicopathological data of the patients were reviewed retrospectively.

Results: The elderly group constituted 30% of study population. More patients in elderly group underwent Hartmann procedure (p=0.02) and right hemicolectomy (p=0.029), and younger patients more often received low anterior resection (p=0.027). The surgical procedure took a shorter time in elderly group (p<0.01) but they stayed in the hospital one day longer (p=0.023). Postoperative complications and mortality tended to be higher in seniors (p=0.088). The younger patients showed a tendency towards a higher rate of distant metastases (p=0.053). Seniors received fewer preoperative chemoradiation than the young group (p=0.014).

Conclusion: Older persons constitute one-third of patients treated electively in colorectal departments. Colorectal surgery in geriatric patients is associated with a prolonged hospital stay and a higher potential for complications and mortality.

Keywords: colorectal cancer; colorectal surgery; elderly.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Colonic Neoplasms / surgery
  • Colorectal Neoplasms / epidemiology
  • Colorectal Neoplasms / surgery*
  • Colorectal Surgery / adverse effects
  • Colorectal Surgery / statistics & numerical data*
  • Female
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Poland
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / prevention & control
  • Postoperative Period*
  • Retrospective Studies
  • Risk Factors