Key result
Laparoscopic colorectal resection in octogenarians is linked to ~70% less postoperative morbidity than open procedures.
Why the study?
The feasibility and safety of laparoscopic colorectal resection among octogenarians was not well established.
Is laparoscopic colorectal resection feasible and safe in octogenarians compared to younger patients and open procedures?
Cohort (n=94)
No
Is laparoscopic colorectal resection feasible and safe in octogenarians compared to younger patients and open procedures?
Absolute Event Rate: 15% vs 50%
p-value: p=0.0001
Laparoscopic colorectal resection is feasible and safe in octogenarians, offering lower morbidity and shorter hospital stays compared to open surgery.
May support laparoscopic over open colorectal resection in octogenarians; extends observational data but leaves open randomized confirmation.
Purpose: To assess the feasibility and safety of laparoscopic colorectal re-section among octogenarians. Method: All patients who underwent laparoscopic colorectal resection were identified from an IRB approved, prospectively maintained laparoscopy database of a single surgeon, between the years 2004-2010. The patients were classified into two subgroups, below and above the age of 80 years (octogenarians and non octogenarians). Also, an additional group of patients, age above >80 years, who underwent open colon or rectal resection, was identified from the departmental database, while matching for age, gender, ASA score, type and indication (benign or malignant) for surgery. The subgroups were compared for postoperative morbidity and recovery parameters. Results: Seventy four patients under-went laparoscopic colorectal resection procedures by a single surgeon (20 octogenarian and 54 non-octogenarian patients). Mean age was 85.2 vs 62.1, respectively. Colon cancer was the most common indication for surgery in both groups of octogenarians. The Conversion rate was comparable between non and octogenarians. Postoperative morbidity rate and length of hospital stay were significantly higher after open procedures as compared to laparoscopic ones, in octogenarian and non octogenarian patients, 50% vs 15% vs 13%, p = 0.0001, and 12.4 vs 8.9 vs 7.6 days, p = 0.01, respectively. Conclusions: Laparoscopic colorectal resection is feasible and safe in octogenarians.
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Khoury et al. (2018) conducted a cohort in Colorectal disease requiring resection (n=94). Laparoscopic colorectal resection vs. Open colorectal resection was evaluated on Postoperative morbidity rate (p=0.0001). Laparoscopic colorectal resection in octogenarians was associated with a significantly lower postoperative morbidity rate compared to open procedures (15% vs 50%, p=0.0001).
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