title: Laparoscopic colorectal surgery: Is it beneficial in the over 80s?
abstract: BACKGROUND
  Advanced age is often associated with higher incidence of co-morbidities, advanced cancer and post-operative complications. The aim of this study was to compare the differences in pre-operative, co-morbidities, cancer stage and surgical outcome measures between patients over the age of 80 and those below 80 undergoing elective laparoscopic colorectal resection.
  
  
  METHODS
  Data were analysed from a prospectively maintained database between February 2011 and June 2012 and patients were subdivided into two groups (over 80 and under 80). All patients underwent laparoscopic colorectal surgery. Their length of stay, high dependency unit/intensive therapy unit stay, American Society of Anaesthesiologists grade, co-morbidities, conversion rates, Dukes' stage and post-operative complication rates were compared.
  
  
  RESULTS
  Of the 67 patients in the study, 57 were <80 at the time of surgery. Their American Society of Anaesthesiologists grade prior to surgery, as expected, was better than that of the >80 group, with 23% having an American Society of Anaesthesiologists grade of 3 compared to 60% in the >80%. The prognosis of the patients in the two groups based on Dukes' stage was similar, with 63% of the <80 s having a good prognosis, compared to 80% in the >80 s. (Good prognosis = Dukes' A or B). The conversion rates were similar (26% of the <80 s compared to 20% of the > 80 s) Post-operative length of stay was also similar in both groups (<80 s vs. >80 s: median 5 vs. 5; p = 0.33). Post-operative complication rates were similar (17% of the <80 s vs. 20% of the >80 s).
  
  
  CONCLUSIONS
  The short-term outcomes following laparoscopic colorectal surgery in the elderly are similar to that of younger patients. Laparoscopic surgery should therefore be offered to all patients irrespective of age.
authors.affiliation: Surgical SHO, General Surgical Department, Northampton General Hospital, UK.
authors.forename: Y
authors.initials: Y
authors.lastname: Tabbakh
authors.affiliation: Consultant Surgeon, General Surgical Department, Northampton General Hospital, UK ugoihedioha@hotmail.com.
authors.forename: U
authors.initials: U
authors.lastname: Ihedioha
authors.affiliation: Surgical Registrar, General Surgical Department, Northampton General Hospital, UK.
authors.forename: S
authors.initials: S
authors.lastname: Panteleimonitis
authors.affiliation: Surgical SHO, General Surgical Department, Northampton General Hospital, UK.
authors.forename: Z
authors.initials: Z
authors.lastname: Gevech
authors.affiliation: Consultant Surgeon, General Surgical Department, Northampton General Hospital, UK.
authors.forename: J
authors.initials: J
authors.lastname: Evans
authors.affiliation: Consultant Surgeon, General Surgical Department, Northampton General Hospital, UK.
authors.forename: P
authors.initials: P
authors.lastname: Kang
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000401:mortality / Q000601:surgery*; D003107:Colorectal Surgery / Q000191:economics / Q000401:mortality; D015897:Comorbidity; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000191:economics / Q000401:mortality; D007902:Length of Stay; D008297:Male; D011183:Postoperative Complications / Q000191:economics / Q000401:mortality; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D018570:Risk Assessment; D014481:United States / Q000453:epidemiology
keywords: Colorectal cancer; laparoscopic colorectal surgery; over 80s