Key result
Minimally invasive surgery reduces 30-day complications and mortality versus open surgery in older colorectal patients.
Why the study?
As older patients increasingly utilize healthcare, comprehensive evidence was needed on the role of minimally invasive surgery for treating colorectal diseases in this population.
Does a minimally invasive approach reduce 30-day complications in patients aged ≥65 years with colorectal diseases compared to open surgery?
Meta-Analysis
Does a minimally invasive approach reduce 30-day complications in patients aged ≥65 years with colorectal diseases compared to open surgery?
Minimally invasive techniques offer clear advantages over open surgery in older patients undergoing colorectal procedures, particularly in reducing complications, mortality, and hospitalization.
Supports minimally invasive surgery as preferred in older colorectal patients; confirms reduced 30-day complications, stay, and mortality.
INTRODUCTION: As life expectancy has been increasing, older patients are becoming more central to the healthcare system, leading to more intensive care use and longer hospital stays. Nevertheless, advancements in minimally invasive surgical techniques offer safe and effective options for older patients with colorectal diseases. This study aims to provide comprehensive evidence on the role of minimally invasive surgery in treating colorectal diseases in older patients. MATERIAL AND METHODS: All articles directly compared the minimally invasive approach with open surgery in patients aged ≥65 years. The present metanalysis took 30-day complications as primary outcomes. Length of hospital stay, readmission, and 30-day mortality were also assessed, as secondary outcomes. Further subgroup analyses were carried out based on surgery setting, lesion features, and location. RESULTS: After searching the main databases, 84 articles were included. Evaluation of 30-day complications rate, length of hospital stay, and 30-day mortality significantly favored minimally invasive approaches. The outcome readmission did not show any significant difference. CONCLUSIONS: The current metanalysis demonstrates clear advantages of minimally invasive techniques over open surgery in colorectal procedures for older patients, particularly in reducing complications, mortality, and hospitalization. This suggests that prioritizing these techniques, based on available expertise and facilities, could improve outcomes and quality of care for older patients undergoing colorectal surgery.
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Ammirati et al. (2024) conducted a meta-analysis in Colorectal cancer. Minimally invasive surgery vs. Open surgery was evaluated on 30-day complications. Minimally invasive surgery significantly reduced 30-day complications, length of hospital stay, and 30-day mortality compared to open surgery in older patients with colorectal diseases.
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