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Surgery Today
Published in: Surgery Today 5/2017

01-05-2017 | Original Article

Comparative benefits of laparoscopic surgery for colorectal cancer in octogenarians: a case-matched comparison of short- and long-term outcomes with middle-aged patients

Authors: Koki Otsuka, Toshimoto Kimura, Masanori Hakozaki, Mizunori Yaegashi, Teppei Matsuo, Hitoshi Fujii, Kei Sato, Tomoki Hatanaka, Akira Sasaki

Published in: Surgery Today | Issue 5/2017

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Abstract

Purpose

The aim of this study was to compare the postoperative short- and long-term outcomes after laparoscopic colorectal surgery (LCS) between octogenarians and healthy middle-aged patients.

Methods

Between January 1997 and July 2009, 655 consecutive laparoscopic surgeries for colorectal cancer patients were operated by 1 colorectal surgeon. Ninety-three patients were octogenarians (≥80 years), and 133 patients were case-matched middle-aged (60–69 years) patients. We analyzed the mean operative time, blood loss, type of surgery for rectal cancer, length of hospital stay, mortality, and morbidity. The overall survival curve was constructed using the Kaplan–Meier method.

Results

The American Society of Anesthesiologists classification was significantly higher in the octogenarians than in the middle-aged controls. However, there were no significant differences between the two groups in terms of the incidence of morbidities (11.7 vs. 9.2 %) and length of hospital stay (12.1 vs. 10.9 days). The number of lymph nodes harvested was significantly fewer (p < 0.05) and the operative time significantly shorter (p < 0.05) in the octogenarians than in the middle-aged controls. At a mean follow-up of 38.2 months, the overall 5-year survival rate was 64.8 % in the octogenarians and 92.4 % in the middle-aged group, whereas the cancer-specific 5-year survival rate was 91 % in the octogenarians and 95.7 % in the middle-aged group.

Conclusions

We suggest that advanced age should not be a contraindication for LCS, even for complex procedures, such as laparoscopic rectal resection.
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Metadata
Title
Comparative benefits of laparoscopic surgery for colorectal cancer in octogenarians: a case-matched comparison of short- and long-term outcomes with middle-aged patients
Authors
Koki Otsuka
Toshimoto Kimura
Masanori Hakozaki
Mizunori Yaegashi
Teppei Matsuo
Hitoshi Fujii
Kei Sato
Tomoki Hatanaka
Akira Sasaki
Publication date
01-05-2017
Publisher
Springer Japan
Published in
Surgery Today / Issue 5/2017
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-016-1410-9

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