title: Laparoscopic versus open surgery for colorectal cancer in the older person: A systematic review.
abstract: BACKGROUND
  Laparoscopic surgery is being increasingly offered to the older person.
  
  
  OBJECTIVE
  To systematically review the literature regarding laparoscopic colorectal cancer surgery in older people and compare to younger adult populations.
  
  
  METHODS
  We included randomized controlled trials that compared open to laparoscopic colorectal cancer surgery. Older people were defined as being 65 years and above.
  
  
  METHODS
  Overall survival and post-operative morbidity and mortality. Secondary endpoints were length of hospital stay, wound recurrence, disease-free survival and conversion rate.
  
  
  RESULTS
  Seven trials included older people, average age of approximately 70 years. Two reported data specific to older patients (over 70 years): The ALCCaS study reported reduced length of stay and short-term complication rates in the laparoscopic group when compared to open surgery (8 versus 10 days, and 36.7% versus 50.6% respectively) and the CLASICC study reported equivalent 5 year survival between arms and a reduction of 2 days length of stay following laparoscopic surgery in older people. In trials which considered data on older and younger participants all five trials reported comparable overall survival and showed comparable or reduced complication rates; two demonstrated significantly shorter length of stay following laparoscopic surgery compared to open surgery.
  
  
  CONCLUSIONS
  Large numbers of older people have been included in well-conducted, multi-centre, randomized controlled trials for laparoscopic and open colorectal cancer surgery. This systematic review suggests that age itself should not be a factor when considering the best surgical option for older patients.
authors.affiliation: General Surgery, Royal Alexandra Hospital, Paisley, Glasgow, United Kingdom.
authors.forename: S J
authors.initials: SJ
authors.lastname: Moug
authors.affiliation: General Surgery, Southmead Hospital, Bristol, United Kingdom.
authors.forename: K
authors.initials: K
authors.lastname: McCarthy
authors.affiliation: Urology, Norfolk and Norwich Hospital, Norwich, United Kingdom.
authors.forename: J
authors.initials: J
authors.lastname: Coode-Bate
authors.affiliation: General Surgery, University Hospital of Wales, Cardiff, United Kingdom.
authors.forename: M J
authors.initials: MJ
authors.lastname: Stechman
authors.affiliation: Department of Academic Geriatric Medicine, Cardiff University, United Kingdom.
authors.forename: J
authors.initials: J
authors.lastname: Hewitt
keywords: Laparoscopic surgery; Older people; Systematic review