Impact of Operative Time on Postoperative Severe Complications in Elderly Patients With Colorectal Cancer: A Multicenter Retrospective Study

PURPOSE: A high proportion of elderly patients have multiple comorbidities, and postoperative complications may contribute to poor outcomes. The purpose of this study is to investigate whether operation time could affect the occurrence of postoperative complications in elderly patients who have undergone colorectal surgery. METHODS: The study included 1316 colorectal cancer patients aged ≥ 80 years who underwent colorectal cancer surgery between 2016 and 2024. We classified patients into two groups based on operative time (≥ 250 min [n = 418] and < 250 min [n = 898]). Clinical and perioperative features were compared between the groups. RESULTS: Blood loss was higher (39 mL vs. 16 mL; p < 0.001), postoperative complications were higher (30.4% vs. 19.8%; p < 0.001), and hospital stay was longer (16 days vs. 14 days; p < 0.001) in the ≥ 250 group. Multivariate analysis revealed that open surgery (p = 0.003; odds ratio 2.438; 95% confidence interval 1.350-4.402) and operative time ≥ 250 min (p = 0.004; odds ratio 1.966; 95% confidence interval 1.233-3.135) were independent predictors for postoperative severe complications. CONCLUSION: In elderly patients undergoing colorectal cancer surgery, high-risk cases should be managed by expert surgeons using minimally invasive techniques and with efforts to minimize operative time.