Australasian Laparoscopic Colon Cancer Study shows that elderly patients may benefit from lower postoperative complication rates following laparoscopic versus open resection.
BACKGROUND
A retrospective analysis of age-related postoperative morbidity in the Australia and New Zealand prospective randomized controlled trial comparing laparoscopic and open resection for right- and left-sided colonic cancer is presented.


METHODS
A total of 592 eligible patients were entered and studied from 1998 to 2005.


RESULTS
Data from 294 patients who underwent laparoscopic and 298 who had open colonic resection were analysed; 266 patients were aged less than 70 years and 326 were 70 years or older (mean(s.d.) 70.3(11.0) years). Forty-three laparoscopic operations (14.6 per cent) were converted to an open procedure. Fewer complications were reported for intention-to-treat laparoscopic resections compared with open procedures (P = 0.002), owing primarily to a lower rate in patients aged 70 years or more (P = 0.002). Fewer patients in the laparoscopic group experienced any complication (P = 0.035), especially patients aged 70 years or above (P = 0.019).


CONCLUSIONS
Treatment choices for colonic cancer depend principally upon disease-free survival; however, patients aged 70 years or over should have rigorous preoperative investigation to avoid conversion and should be considered for laparoscopic colonic resection.


BACKGROUND
NCT00202111 (http://www.clinicaltrials.gov).
Allardyce
R A
RA
Department of Surgery, University of Otago, Christchurch, New Zealand. randall.allardyce@otago.ac.nz
Bagshaw
P F
PF
Frampton
C M
CM
Frizelle
F A
FA
Hewett
P J
PJ
Rieger
N A
NA
Smith
J S
JS
Solomon
M J
MJ
Stevenson
A R L
AR
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D011788:Quality of Life; D012189:Retrospective Studies