title: Laparoscopic colorectal surgery is safe and benefits octogenarian patients with malignant disease: a matched case-control study comparing laparoscopic and open colorectal surgery.
abstract: OBJECTIVE
  Increased physiological stress from laparoscopic surgery and the lower physiological reserves in the elderly are causes for concern. This study aims to compare the outcomes between laparoscopic and open colorectal surgery in octogenarians.
  
  
  METHODS
  Octogenarians who underwent elective colorectal resections from 2000 to 2011 were reviewed. Patients who underwent laparoscopic surgery were matched for comorbidities, T-staging and type of resection performed to patients with open surgery.
  
  
  RESULTS
  Each group had 36 patients. Both groups were comparable for median age (85 vs 83, p = 0.43), gender (21 vs 18 males, p = 0.64) and the American Society of Anaesthesiologists (ASA) score (p = 0.486). Both groups had comparable median maximal tumour dimensions (4.75 vs 4.25 cm, p = 0.38) and median number of lymph nodes harvested (15 vs 14, p = 0.94). The laparoscopic group had, however, a longer median operative time (167.5 vs 124.5 min, p < 0.001). Both groups had comparable median length of hospitalisation (8 vs 7, p = 0.83), number of complications with a grade of complication (GOC) of ≥3 (5 vs 7, p = 0.75) and 30-day mortality rates (8.3 vs 5.6%, p = 1.00). One-year survival rate for the open group was lower (75.0 vs 94.4%, p = 0.09).
  
  
  CONCLUSIONS
  Despite a longer operating time, laparoscopic surgery had comparable short-term outcomes and might have a long-term survival benefit.
authors.affiliation: Division of Colorectal Surgery, Department of Surgery, University Surgical Cluster, National University Hospital, National University Health System, 1E Kent Ridge Road, Singapore, 119228, Singapore.
authors.forename: Frederick H
authors.initials: FH
authors.lastname: Koh
authors.forename: Jiayi
authors.initials: J
authors.lastname: Wong
authors.forename: Jarrod K
authors.initials: JK
authors.lastname: Tan
authors.forename: Ker-Kan
authors.initials: KK
authors.lastname: Tan
authors.forename: Wai-Kit
authors.initials: WK
authors.lastname: Cheong
authors.forename: Bettina
authors.initials: B
authors.lastname: Lieske
mesh_terms: D000369:Aged, 80 and over; D016022:Case-Control Studies; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D003107:Colorectal Surgery; D003710:Demography; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D011182:Postoperative Care