Skip to main content
Top
Published in: Techniques in Coloproctology 3/2012

01-06-2012 | Original Article

Laparoscopy for sigmoid colon and rectal cancers in septuagenarians: a retrospective, comparative study

Authors: Y. E. Altuntas, C. Gezen, S. Vural, N. Okkabaz, M. Kement, M. Oncel

Published in: Techniques in Coloproctology | Issue 3/2012

Login to get access

Abstract

Background

The aim of the study is to analyze the results of laparoscopy in septuagenarians with sigmoid colon or rectal cancer.

Methods

Patients who underwent laparoscopic or hand-assisted laparoscopic sigmoid or rectal resections for cancer were retrospectively selected from the database of our institution. The study group (Lap > 70 group), contained the cancer patients over 70 years old who were treated with laparoscopy. Patients less than 70 years old who underwent a laparoscopic procedure (Lap < 70 group), and those over than 70 years old who underwent conventional surgery (Open > 70 group), were assigned to control groups. Demographics, information regarding tumors, perioperative data, pathological results, and survival in the three groups were compared.

Results

There were 56, 166, and 34 patients in the Lap > 70, Lap < 70, and Open > 70 groups, respectively. Patients in the Lap > 70 group were significantly older than other groups. The American Society of Anesthesiologists scores were higher, and the presence of the studied risk factors was more common in the Lap > 70 group than the Lap < 70 group. Intraoperative bleeding and the amount and number of perioperative transfusions required were less in the Lap > 70 group than in the Open > 70 group. The number of harvested lymph nodes was less in the Lap > 70 group than both study groups. Five-year survival in the Lap > 70 group was similar to that in the Lap < 70 group and significantly better than in the Open > 70 group.

Conclusions

Laparoscopy for sigmoid colon and rectal cancer in patients over 70 may be feasible and safe as it is in younger patients. The present study has revealed that laparoscopy in the elderly may be superior to conventional techniques as regards some intraoperative findings and survival.
Literature
1.
go back to reference Frasson M, Braga M, Vignali A, Zuliani W, Di Carlo V (2008) Benefits of laparoscopic colorectal resection are more pronounced in elderly patients. Dis Colon Rectum 51:296–300PubMedCrossRef Frasson M, Braga M, Vignali A, Zuliani W, Di Carlo V (2008) Benefits of laparoscopic colorectal resection are more pronounced in elderly patients. Dis Colon Rectum 51:296–300PubMedCrossRef
2.
go back to reference Liang JT, Shieh MJ, Chen CN, Cheng YM, Chang KJ, Wang SM (2002) Prospective evaluation of laparoscopy-assisted colectomy versus laparotomy with resection for management of complex polyps of the sigmoid colon. World J Surg 26:377–383PubMedCrossRef Liang JT, Shieh MJ, Chen CN, Cheng YM, Chang KJ, Wang SM (2002) Prospective evaluation of laparoscopy-assisted colectomy versus laparotomy with resection for management of complex polyps of the sigmoid colon. World J Surg 26:377–383PubMedCrossRef
3.
go back to reference Braga M, Vignali A, Gianotti L et al (2002) Laparoscopic versus open colorectal surgery. A randomized trial on short-term outcome. Ann Surg 236:759–767PubMedCrossRef Braga M, Vignali A, Gianotti L et al (2002) Laparoscopic versus open colorectal surgery. A randomized trial on short-term outcome. Ann Surg 236:759–767PubMedCrossRef
4.
go back to reference Abraham NS, Young JM, Solomon MJ (2004) Meta-analysis of short-term outcomes after laparoscopic resection for colorectal cancer. Br J Surg 91:1111–1124PubMedCrossRef Abraham NS, Young JM, Solomon MJ (2004) Meta-analysis of short-term outcomes after laparoscopic resection for colorectal cancer. Br J Surg 91:1111–1124PubMedCrossRef
5.
go back to reference Leung KL, Kwok SP, Lam SC et al (2004) Laparoscopic resection of rectosigmoid carcinoma: prospective randomised trial. Lancet 363:1187–1192PubMedCrossRef Leung KL, Kwok SP, Lam SC et al (2004) Laparoscopic resection of rectosigmoid carcinoma: prospective randomised trial. Lancet 363:1187–1192PubMedCrossRef
6.
go back to reference Nelson H, Sargent DJ, Wieand HS et al (2004) A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med 350:2050–2059CrossRef Nelson H, Sargent DJ, Wieand HS et al (2004) A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med 350:2050–2059CrossRef
7.
go back to reference Lacy AM, Garcia-Valdecasas JC, Delgado S et al (2002) Laparoscopic assisted colectomy vs. open colectomy for treatment of nonmetastatic colon cancer: a randomized trial. Lancet 359:2224–2229PubMedCrossRef Lacy AM, Garcia-Valdecasas JC, Delgado S et al (2002) Laparoscopic assisted colectomy vs. open colectomy for treatment of nonmetastatic colon cancer: a randomized trial. Lancet 359:2224–2229PubMedCrossRef
8.
go back to reference Feng B, Zheng MH, Mao ZH et al (2006) Clinical advantages of laparoscopic colorectal cancer surgery in the elderly. Aging Clin Exp Res 18:191–195PubMed Feng B, Zheng MH, Mao ZH et al (2006) Clinical advantages of laparoscopic colorectal cancer surgery in the elderly. Aging Clin Exp Res 18:191–195PubMed
9.
go back to reference Vignali A, Di Palo S, Tamburini A, Radaelli G, Orsenigo E, Staudacher C (2005) Laparoscopic vs. open colectomies in octogenarians: a case-matched control study. Dis Colon Rectum 48:2070–2075PubMedCrossRef Vignali A, Di Palo S, Tamburini A, Radaelli G, Orsenigo E, Staudacher C (2005) Laparoscopic vs. open colectomies in octogenarians: a case-matched control study. Dis Colon Rectum 48:2070–2075PubMedCrossRef
10.
go back to reference Sklow B, Read T, Birnbaum E, Fry R, Fleshman J (2003) Age and type of procedure influence the choice of patients for laparoscopic colectomy. Surg Endosc 17:923–929PubMedCrossRef Sklow B, Read T, Birnbaum E, Fry R, Fleshman J (2003) Age and type of procedure influence the choice of patients for laparoscopic colectomy. Surg Endosc 17:923–929PubMedCrossRef
11.
go back to reference Yamamoto S, Watanabe M, Hasegawa H, Baba H, Kitajima M (2003) Short-term outcomes of laparoscopic colonic surgery in octogenarians: a matched case-control study. Surg Laparosc Endosc Percutan Tech 13:95–100PubMedCrossRef Yamamoto S, Watanabe M, Hasegawa H, Baba H, Kitajima M (2003) Short-term outcomes of laparoscopic colonic surgery in octogenarians: a matched case-control study. Surg Laparosc Endosc Percutan Tech 13:95–100PubMedCrossRef
12.
go back to reference Senagore AJ, Madbouly KM, Fazio VW, Duepree HJ, Brady KM, Delaney CP (2003) Advantages of laparoscopic colectomy in older patients. Arch Surg 138:252–256PubMedCrossRef Senagore AJ, Madbouly KM, Fazio VW, Duepree HJ, Brady KM, Delaney CP (2003) Advantages of laparoscopic colectomy in older patients. Arch Surg 138:252–256PubMedCrossRef
13.
go back to reference Law WL, Chu KW, Ming Tung PH (2002) Laparoscopic colorectal resection: a safe option for elderly patients. J Am Coll Surg 195:768–773PubMedCrossRef Law WL, Chu KW, Ming Tung PH (2002) Laparoscopic colorectal resection: a safe option for elderly patients. J Am Coll Surg 195:768–773PubMedCrossRef
14.
go back to reference Delgado S, Lacy AM, Garcia Valdecasas JC et al (2000) Could age be an indication for laparoscopic colectomy in colorectal cancer? Surg Endosc 14:22–26PubMedCrossRef Delgado S, Lacy AM, Garcia Valdecasas JC et al (2000) Could age be an indication for laparoscopic colectomy in colorectal cancer? Surg Endosc 14:22–26PubMedCrossRef
15.
go back to reference Stocchi L, Nelson H, Young-Fadok TM, Larson DR, Ilstrup DM (2000) Safety and advantages of laparoscopic vs. Open colectomy in the elderly: matched-control study. Dis Colon Rectum 43:326–332PubMedCrossRef Stocchi L, Nelson H, Young-Fadok TM, Larson DR, Ilstrup DM (2000) Safety and advantages of laparoscopic vs. Open colectomy in the elderly: matched-control study. Dis Colon Rectum 43:326–332PubMedCrossRef
16.
go back to reference Stewart BT, Stitz RW, Lumley JW (1999) Laparoscopically assisted colorectal surgery in the elderly. Br J Surg 86:938–941PubMedCrossRef Stewart BT, Stitz RW, Lumley JW (1999) Laparoscopically assisted colorectal surgery in the elderly. Br J Surg 86:938–941PubMedCrossRef
17.
go back to reference Fiscon V, Portale G, Frigo F, Migliorini G (2010) Laparoscopic resection of colorectal cancer: matched comparison in elderly and younger patients. Tech Coloproctol 14:323–327PubMedCrossRef Fiscon V, Portale G, Frigo F, Migliorini G (2010) Laparoscopic resection of colorectal cancer: matched comparison in elderly and younger patients. Tech Coloproctol 14:323–327PubMedCrossRef
18.
go back to reference Reissman P, Agachan F, Wexner SD (1996) Outcome of laparoscopic colorectal surgery in older patients. Am Surg 62:1060–1063PubMed Reissman P, Agachan F, Wexner SD (1996) Outcome of laparoscopic colorectal surgery in older patients. Am Surg 62:1060–1063PubMed
19.
go back to reference Oncel M, Akin T, Gezen FC, Alici A, Okkabaz N (2009) Left inferior quadrant oblique incision: a new access for hand-assisted device during laparoscopic low anterior resection of rectal cancer. J Laparoendosc Adv Surg Tech A 19:663–666PubMedCrossRef Oncel M, Akin T, Gezen FC, Alici A, Okkabaz N (2009) Left inferior quadrant oblique incision: a new access for hand-assisted device during laparoscopic low anterior resection of rectal cancer. J Laparoendosc Adv Surg Tech A 19:663–666PubMedCrossRef
20.
go back to reference Kwok SP, Lau WY, Carey PD, Kelly SB, Leung KL, Li AK (1996) Prospective evaluation of laparoscopic-assisted large bowel excision for cancer. Ann Surg 223:170–176PubMedCrossRef Kwok SP, Lau WY, Carey PD, Kelly SB, Leung KL, Li AK (1996) Prospective evaluation of laparoscopic-assisted large bowel excision for cancer. Ann Surg 223:170–176PubMedCrossRef
21.
go back to reference Wexner SD, Cohen SM, Johansen OB, Nogueras JJ, Jagelman DG (1993) Laparoscopic colorectal surgery. A prospective assessment and current perspective. Br J Surg 80:1602–1605PubMedCrossRef Wexner SD, Cohen SM, Johansen OB, Nogueras JJ, Jagelman DG (1993) Laparoscopic colorectal surgery. A prospective assessment and current perspective. Br J Surg 80:1602–1605PubMedCrossRef
22.
go back to reference Seshadri PA, Mamazza J, Schlachta CM, Cadeddu MO, Poulin EC (2001) Laparoscopic colorectal resection in octogenarians. Surg Endosc 15:802–805PubMedCrossRef Seshadri PA, Mamazza J, Schlachta CM, Cadeddu MO, Poulin EC (2001) Laparoscopic colorectal resection in octogenarians. Surg Endosc 15:802–805PubMedCrossRef
23.
go back to reference Heriot AG, Tekkis PP, Smith JJ (2006) Prediction of postoperative mortality in elderly patients with colorectal cancer. Dis Colon Rectum 49:816–824PubMedCrossRef Heriot AG, Tekkis PP, Smith JJ (2006) Prediction of postoperative mortality in elderly patients with colorectal cancer. Dis Colon Rectum 49:816–824PubMedCrossRef
24.
go back to reference Roscio F, Bertoglio C, De Luca A, Frigerio A, Galli F, Scandroglio I (2011) Outcomes of laparoscopic surgery for colorectal cancer in elderly patients. JSLS 15:315–321PubMedCrossRef Roscio F, Bertoglio C, De Luca A, Frigerio A, Galli F, Scandroglio I (2011) Outcomes of laparoscopic surgery for colorectal cancer in elderly patients. JSLS 15:315–321PubMedCrossRef
25.
go back to reference Spivak H, Maele DV, Friedman I, Nussbaum M (1996) Colorectal surgery in octogenarians. J Am Coll Surg 183:46–50PubMed Spivak H, Maele DV, Friedman I, Nussbaum M (1996) Colorectal surgery in octogenarians. J Am Coll Surg 183:46–50PubMed
26.
go back to reference Wise WE Jr, Padmanabhan A, Meesig DM, Arnold MW, Aguilar PS, Stewart WR (1991) Abdominal colon and rectal operations in elderly. Dis Colon Rectum 34:959–963PubMedCrossRef Wise WE Jr, Padmanabhan A, Meesig DM, Arnold MW, Aguilar PS, Stewart WR (1991) Abdominal colon and rectal operations in elderly. Dis Colon Rectum 34:959–963PubMedCrossRef
27.
go back to reference Elferink MA, Siesling S, Lemmens VE et al (2011) Variation in lymph node evaluation in rectal cancer: a Dutch nationwide population-based study. Ann Surg Oncol 18:386–395PubMedCrossRef Elferink MA, Siesling S, Lemmens VE et al (2011) Variation in lymph node evaluation in rectal cancer: a Dutch nationwide population-based study. Ann Surg Oncol 18:386–395PubMedCrossRef
28.
go back to reference Kennedy GD, Rajamanickam V, O’Connor ES et al (2011) Optimizing surgical care of colon cancer in the older adult population. Ann Surg 253:508–514PubMedCrossRef Kennedy GD, Rajamanickam V, O’Connor ES et al (2011) Optimizing surgical care of colon cancer in the older adult population. Ann Surg 253:508–514PubMedCrossRef
29.
go back to reference Puig-La Calle J Jr, Quayle J, Thaler HT et al (2000) Favorable short-term and long-term outcome after elective radical rectal cancer resection in patients 75 years of age or older. Dis Colon Rectum 43:1704–1709PubMedCrossRef Puig-La Calle J Jr, Quayle J, Thaler HT et al (2000) Favorable short-term and long-term outcome after elective radical rectal cancer resection in patients 75 years of age or older. Dis Colon Rectum 43:1704–1709PubMedCrossRef
Metadata
Title
Laparoscopy for sigmoid colon and rectal cancers in septuagenarians: a retrospective, comparative study
Authors
Y. E. Altuntas
C. Gezen
S. Vural
N. Okkabaz
M. Kement
M. Oncel
Publication date
01-06-2012
Publisher
Springer Milan
Published in
Techniques in Coloproctology / Issue 3/2012
Print ISSN: 1123-6337
Electronic ISSN: 1128-045X
DOI
https://doi.org/10.1007/s10151-012-0817-6

Other articles of this Issue 3/2012

Techniques in Coloproctology 3/2012 Go to the issue