title: Outcome of laparoscopic versus open resection for rectal cancer in elderly patients.
abstract: BACKGROUND
  Laparoscopic colorectal resection has been gaining popularity over the past two decades. However, studies about laparoscopic rectal surgery in elderly patients with long-term oncologic outcomes are limited. In this study, we evaluated the short-term and long-term outcomes of laparoscopic and open resection in patients with rectal cancer aged ≥ 70 y.
  
  
  METHODS
  From 2007-2012, a total of 294 consecutive patients with rectal cancer from a single institution were included, 112 patients undergoing laparoscopic rectal resection were compared with 182 patients undergoing open rectal resection.
  
  
  RESULTS
  Seven (6.3%) patients in the laparoscopic group required conversion to open surgery. The two groups were well balanced in terms of age, gender, body mass index, American society of anesthesiologists scores, site, and stage of the tumors. Laparoscopic surgery was associated with significantly longer median operating time (220 versus 200 min; P = 0.005), less estimated blood loss (100 versus 150 mL; P < 0.001), a shorter postoperative hospital stay (8 versus 11 d), lower overall postoperative complication rate (15.2% versus 26.4%; P = 0.025), wound-related complication rate (7.14% versus 17.03%; P = 0.015), less need of blood transfusion (8.04% versus 16.5%; P = 0.038), and surgical intensive care unit after surgery (12.5% versus 22.0%; P = 0.042) when compared with open surgery. Mortality, quality of surgical specimen, lymph nodes harvested, positive distal, and circumferential margin rate were not significantly different between two groups. The estimated 3-y survival rates were similar between two groups.
  
  
  CONCLUSIONS
  Laparoscopic rectal surgery is safe and feasible in patients >70 y and is associated with better short-term outcomes when compared with open surgery.
authors.affiliation: Department of Colorectal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Chaoyang District, Beijing, China.
authors.forename: Wei-gen
authors.initials: WG
authors.lastname: Zeng
authors.affiliation: Department of Colorectal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Chaoyang District, Beijing, China. Electronic address: zhzhxpumc@163.com.
authors.forename: Zhi-xiang
authors.initials: ZX
authors.lastname: Zhou
authors.affiliation: The Overall Planning Office, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Chaoyang District, Beijing, China.
authors.forename: Hui-rong
authors.initials: HR
authors.lastname: Hou
authors.affiliation: Department of Colorectal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Chaoyang District, Beijing, China.
authors.forename: Jian-wei
authors.initials: JW
authors.lastname: Liang
authors.affiliation: Department of Colorectal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Chaoyang District, Beijing, China.
authors.forename: Hai-tao
authors.initials: HT
authors.lastname: Zhou
authors.affiliation: Department of Colorectal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Chaoyang District, Beijing, China.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Colorectal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Chaoyang District, Beijing, China.
authors.forename: Xing-mao
authors.initials: XM
authors.lastname: Zhang
authors.affiliation: Department of Colorectal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Chaoyang District, Beijing, China.
authors.forename: Jun-jie
authors.initials: JJ
authors.lastname: Hu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002681:China / Q000453:epidemiology; D013505:Digestive System Surgical Procedures / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000706:statistics & numerical data*; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D012004:Rectal Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Elderly patients; Laparoscopic rectal surgery; Morbidity; Outcome; Rectal cancer