Indications and advantages of laparoscopy-assisted colon resection for carcinoma in elderly patients.
The controversy about laparoscopy assisted colectomy for cancer is based on doubt about performing a radical resection and adequate histopathological staging. Therefore, we selected a group of patients who could profit from the accepted benefits of the technique, while avoiding its uncontrolled outcome. We operated on patients with colorectal cancer with distant metastasis and on patients over 70 years old and American Society of Anesthesia (ASA) III-IV with a high operative risk with standard surgery. The results for the first 18 patients demonstrated the following: (a) the size of the surgical specimen and the number of lymph nodes were similar to those in standard surgery; (b) no mortality and very low morbidity occurred despite the patients' advanced age, debilitated condition, and comorbid diseases; (c) minor postoperative complications occurred in five of 18 patients; (d) the hospital stay was 6-7 days for nonmetastatic patients and 9-12 days for metastatic patients; (e) the 1-year survey revealed a relapse in only one patient 9 months after the first operation.
Vara-Thorbeck
C
C
Department of Surgery, University Hospital, Málaga, Spain.
Garcia-Caballero
M
M
Salvi
M
M
Gutstein
D
D
Toscano
R
R
Gómez
A
A
Vara-Thorbeck
R
R
D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007415:Intestinal Obstruction / Q000517:prevention & control; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D011788:Quality of Life