title: Evaluation of laparoscopic versus open colorectal surgery in elderly patients more than 70 years old: an evaluation of 727 patients.
abstract: BACKGROUND
  With longer life expectancy, surgeons can expect to operate on older patients. Laparoscopic colorectal (LC) surgery has been demonstrated to be superior to open surgery. Controversy persists, however, regarding benefits of LC in the elderly due to increase in operative time. The aim of our study was to compare short-term outcomes of LC versus open colorectal (OC) surgery in elderly patients.
  
  
  METHODS
  Patients ≥70 years old that underwent elective LC between 2005 and 2008 were compared with controls who underwent OC. Data was extracted from a prospectively collected database.
  
  
  RESULTS
  Seven hundred and twenty-seven patients underwent colorectal resection in this study period (LC n = 225, OC n = 502). The laparoscopic arm was characterised by shorter incisions (LC 6.0 cm vs. OC 12.0 cm, p < 0.001) but longer operating times (LC 125 min vs. OC 85 min, p < 0.001). Median use of narcotics and length of stay were significantly shorter in the laparoscopic group (LC 2 days vs. OC 3 days, p < 0.001 and LC 6 days vs. OC 7 days, p < 0.001, respectively). There was no significant difference in median recovery of bowel function (LC 4 days vs. OC 4 days, p = 0.14) and post-operative morbidity (p = 0.725). Thirty-day mortality was significantly lower in the laparoscopic arm (LC 1.3% vs. OC 4.6%, p = 0.03)
  
  
  CONCLUSIONS
  This is the largest series from a single institution comparing LC and OC in elderly patients. In our series, LC in elderly patients was safe and not associated with a higher morbidity. LC was also associated with less narcotic use and shorter length of stay.
authors: Department of Colorectal Surgery, Singapore General Hospital, Outram Road, Singapore, 169608.
authors: Wah Siew
authors: WS
authors: Tan
authors: Min Hoe
authors: MH
authors: Chew
authors: Irene Ai Ling
authors: IA
authors: Lim
authors: Kheng Hong
authors: KH
authors: Ng
authors: Choong Leong
authors: CL
authors: Tang
authors: Kong Weng
authors: KW
authors: Eu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D003107:Colorectal Surgery / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D011182:Postoperative Care; D011183:Postoperative Complications / Q000209:etiology