[Use of mechanical staplers in the surgical treatment of rectal cancer in the elderly].
The aim of this study was to analyze the changes in surgical treatment of rectal cancer and in postsurgical complications as a result of the introduction of staplers in surgical practice, with particular reference to elderly patients (> or = 75 years). Since 1976, 320 patients have undergone rectal surgery in our department (207 colo-rectal or colo-anal anastomoses and 113 Miles operations have been performed). The patients were subdivided into two groups on the basis of age (> or = and < 75 years) and then further divided into subgroups operated on before and after 1983 (the year staplers were introduced). The morbidity rate (fistulas) was 16% in patients < 75 years old and 12% in elderly patients (P = n.s.); the mortality rate was 1% in patients < 75 years old and 12% in the more elderly group (P < 0.001). The utilization of staplers in surgical treatment of rectal cancer allows the surgeon to perform sphincter-sparing resections even in elderly patients without any changes in specific morbidity. Nevertheless, the complications are more severe in the elderly, with a higher mortality rate.
Montesani
C
C
Università degli Studi di Roma La Sapienza, Policlinico Umberto I, VI Clinica Chirurgica, V.le del Policlinico, 155, 00161 Roma.
Pronio
A
A
Santella
S
S
Manzi
F
F
Gentili
V
V
Boschetto
A
A
Vestri
A
A
D'Amato
A
A
D000367:Age Factors; D000368:Aged; D006801:Humans; D011183:Postoperative Complications / Q000453:epidemiology; D012004:Rectal Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D013528:Surgical Staplers / Q000009:adverse effects