Relevance of Age and Preoperative Risk in Laparoscopic Colorectal Surgery

Summary: Background:We assessed the outcome of various laparoscopic colorectal procedures according to different ages and risk groups. Methods: The results of 25 patients under 70 years (Group I) were compared with the results of 26 patients, 70 years and older (Group II). Both groups were matched for gender, indications for surgery and operative procedures. Results: The preoperative risk was significantly higher in Group II, in which 77 % of patients corresponded to ASA III compared to 28 % in Group I, p ≤ 0.001. A significant smaller number of preoperative blood transfusions was required in Group II, p ≤ 0.01. No significant differences were found between Group I and Group II due to conversion rate (16 % vs. 4 %), complications (16 % vs. 27 %) and reoperation rate (12 % for both). Postoperative mortality was only slightly higher in Group II (3/12 %), compared to Group I (1/4 %). 2 of 3 exitus in Group II were related to cardiopulmonary complications. Concerning fast postoperative recovery, analgesics consumption and first bowel movement were similar for both groups. Conclusions: Compared to younger patients the elderly can benefit from laparoscopic colorectal techniques as well. However they must be carefully selected with respect to their preoperative risk and associated comorbidity.