title: Rectal cancer surgery in older people does not increase postoperative complications--a retrospective analysis.
abstract: BACKGROUND
  Rectal cancer surgery in the older population remains a highly controversial topic. The present study was designed to assess whether older patients had an increased risk for postoperative complications after rectal resection for malignancies.
  
  
  METHODS
  Consecutive patients (n=627), who underwent rectal cancer resection at a single institution, were included in the study and analyzed retrospectively. Short-term complications were compared between patients≥80 years (n=55) and <80 years (n=572). Additionally, predictive factors for postoperative complications were analyzed.
  
  
  RESULTS
  The older aged group showed a significantly higher rate of co-morbidities compared to controls, in terms of cardiovascular and pulmonary diseases (P=0.002, P=0.006). In older patients, a Hartmann's procedure and transanal endoscopic microsurgery (TEM) were performed most frequently (P<0.0001).The overall complication rate was 39% (n=244) (medical: n=59 (9%), surgical: n=185 (30%)), including 24 (44%) complications in the older aged group (medical: n=6 (11%), surgical: n=18 (33%)). Notably, the incidence of surgical and medical complications showed no significant difference between patients and controls (P=0.58, P=0.69).Neurological and cardiovascular disorders were associated with an increased risk for a eventful postoperative course in the older aged group (P=0.03, P=0.04).
  
  
  CONCLUSIONS
  Rectal cancer resection can be performed safely in selected older patients. Age itself should not be considered as a risk factor for postoperative complications.
authors.forename: Jagdeep
authors.initials: J
authors.lastname: Singh
authors.forename: Anton
authors.initials: A
authors.lastname: Stift
authors.forename: Sarah
authors.initials: S
authors.lastname: Brus
authors.forename: Katharina
authors.initials: K
authors.lastname: Kosma
authors.forename: Martina
authors.initials: M
authors.lastname: Mittlböck
authors.affiliation: Department of Surgery, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria. stefan.riss@meduniwien.ac.at.
authors.forename: Stefan
authors.initials: S
authors.lastname: Riss
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D013505:Digestive System Surgical Procedures; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications; D011379:Prognosis; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult