Age and comorbidities do not affect short-term outcomes after laparoscopic rectal cancer resection in elderly patients. A multi-institutional cohort study in 287 patients.
Roberto PeltriniNicola ImperatoreFilippo CarannanteDiego CuccurulloGabriella Teresa CapolupoUmberto BracaleMarco CaricatoFrancesco CorcionePublished in: Updates in surgery (2021)
Postoperative complications and mortality rates after rectal cancer surgery are higher in elderly than in non-elderly patients. The aim of this study is to evaluate whether, like in open surgery, age and comorbidities affect postoperative outcomes limiting the benefits of a laparoscopic approach. Between April 2011 and July 2020, data of 287 patients with rectal cancer submitted to laparoscopic rectal resection from different institutions were collected in an electronic database and were categorized into two groups: < 75 years and ≥ 75 years of age. Perioperative data and short-term outcomes were compared between these groups. Risk factors for postoperative complications were determined on multivariate analysis, including age groups and previous comorbidities as variables. Seventy-seven elderly patients had both higher ASA scores (p < 0.001) and cardiovascular disease rates (p = 0.02) compared with 210 non-elderly patients. There were no significative differences between groups in terms of overall postoperative complications (p = 0.3), number of patients with complications (p = 0.2), length of stay (p = 0.2) and death during hospitalization (p = 0.9). The only independent variables correlated with postoperative morbidity were male gender (OR 2.56; 95% CI 1.53-3.68, p < 0.01) and low-medium localization of the tumor (OR 2.12; 75% CI 1.43-4.21, p < 0.01). Although older people are more frail patients, short-term postoperative outcomes in patients ≥ 75 years of age were similar to those of younger patients after laparoscopic surgery for rectal cancer. Elderly patients benefit from laparoscopic rectal resection as well as non-elderly patient, despite advanced age and comorbidities.
Keyphrases
- rectal cancer
- end stage renal disease
- cardiovascular disease
- ejection fraction
- newly diagnosed
- peritoneal dialysis
- minimally invasive
- prognostic factors
- patients undergoing
- locally advanced
- type diabetes
- squamous cell carcinoma
- radiation therapy
- emergency department
- mental health
- electronic health record
- cardiovascular risk factors