title: Is laparoscopic colorectal surgery beneficial for elderly patients? A systematic review and meta-analysis.
abstract: BACKGROUND
  Elderly patients who undergo major abdominal surgery are potentially at a higher risk of perioperative mortality and postoperative complications. Although laparoscopic surgery has been widely accepted as a less invasive surgical procedure for colorectal diseases, the benefits for elderly patients have not been validated.
  
  
  OBJECTIVE
  To compare postoperative outcomes and long-term survival between laparoscopic and open colorectal surgery in the elderly population.
  
  
  METHODS
  A literature search was electronically performed to identify all studies comparing postoperative outcomes between laparoscopic and open colorectal resections in the elderly population. Primary outcomes were postoperative mortality and complications, and the secondary outcome was long-term survival.
  
  
  RESULTS
  Overall, 30 studies (70,946 patients) met our inclusion criteria. Laparoscopic surgery was significantly associated with a decreased risk of perioperative mortality [odds ratio (OR), 0.55; 95% confidence interval (CI), 0.45-0.68; P < 0.01] and postoperative complications (OR, 0.55; 95% CI, 0.48-0.63; P < 0.01) compared with open surgery. There was no significant difference in long-term survival between the two procedures (OR, 0.89; 95% CI, 0.72-1.07; P = 0.31).
  
  
  CONCLUSIONS
  Laparoscopic colorectal surgery in the elderly population has significant advantages in terms of short-term outcomes. Aggressive application of laparoscopic colorectal surgery should be considered for the elderly population.
authors.affiliation: Department of Surgery, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo, 1608582, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Seishima
authors.forename: Koji
authors.initials: K
authors.lastname: Okabayashi
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Hasegawa
authors.forename: Masashi
authors.initials: M
authors.lastname: Tsuruta
authors.forename: Kohei
authors.initials: K
authors.lastname: Shigeta
authors.forename: Shimpei
authors.initials: S
authors.lastname: Matsui
authors.forename: Toru
authors.initials: T
authors.lastname: Yamada
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kitagawa
mesh_terms: D000367:Age Factors; D000368:Aged; D003108:Colonic Diseases / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D011183:Postoperative Complications; D012002:Rectal Diseases / Q000601:surgery*