title: Short- and long-term outcomes of laparoscopic surgery for colorectal cancer in the elderly: A prospective cohort study.
abstract: BACKGROUND
  The aim of this study was to evaluate the safety and validity of laparoscopic colorectal surgery for elderly patients. We compared the short and long-term postoperative outcomes of laparoscopic colorectal surgery in patients aged ≥75 years (elderly patients; EP) and <75 years (relatively younger patients; RP).
  
  
  METHODS
  Clinicopathological data and short- and long-term outcomes after laparoscopic surgery for colorectal cancer were compared between the EP (n = 53) and RP groups (n = 155).
  
  
  RESULTS
  In the EP group, patients with American Society of Anesthesiologists score II (p = 0.047) and medical comorbidity rate (EP vs RP: 83.0% vs 56.8%, p < 0.001), especially for cardiovascular disease (64.2% vs 37.5%, p < 0.001) and diabetes mellitus (20.8% vs 9.7%, p = 0.044), were significantly higher than those in the RP group. Regarding the clinical characteristics, the ratio of right colectomy (50.9% vs 25.3%, p < 0.001) and pathological tumor grade T4 (18.9% vs 7.7%, p = 0.044) were significantly higher in the EP group. There was no significant difference in the variation of pathological stage between the two groups. In the postoperative course, there were no significant differences regarding short-term postoperative outcomes between the EP and RP groups, including that for timing of oral diet tolerance (3.9 days vs 3.5 days, p = 0.073), first flatus (2.3 days vs 2.0 days, p = 0.636), first bowel movement (3.3 days vs 3.7 days, p = 0.153), ambulation after surgery (1.7 days vs 1.5 days, p = 0.081), postoperative hospital stay (10.5 days vs 10.8 days, p = 0.469), and incidence of postoperative complications (20.8% vs 15.5%, p = 0.385), respectively. Regarding the long-term outcomes, there were no significant differences in recurrence-free survival (RFS) (5-year RFS, 74.0% vs 85.2%, p = 0.091) and overall survival (OS) (5-year OS, 81.8% vs 90.1%, p = 0.112) between the two groups.
  
  
  CONCLUSIONS
  Laparoscopic colorectal surgery in elderly patients was safe and well-tolerated in comparison with the relatively younger patients.
authors.affiliation: Kansai Medical University, Department of Surgery, 10-15 Fumizonocho, Moriguchi, Osaka, 570-8507, Japan. Electronic address: tokuhark@takii.kmu.ac.jp.
authors.forename: Katsuji
authors.initials: K
authors.lastname: Tokuhara
authors.affiliation: Kansai Medical University, Department of Surgery, 10-15 Fumizonocho, Moriguchi, Osaka, 570-8507, Japan.
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Nakatani
authors.affiliation: Kansai Medical University, Department of Surgery, 10-15 Fumizonocho, Moriguchi, Osaka, 570-8507, Japan.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Ueyama
authors.affiliation: Kansai Medical University, Department of Surgery, 10-15 Fumizonocho, Moriguchi, Osaka, 570-8507, Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Yoshioka
authors.affiliation: Kansai Medical University, Department of Surgery, 10-15 Fumizonocho, Moriguchi, Osaka, 570-8507, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Kon
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy / Q000379:methods / Q000706:statistics & numerical data*; D015179:Colorectal Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000379:methods / Q000706:statistics & numerical data*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D011446:Prospective Studies
keywords: Colorectal cancer; Elderly; Laparoscopic surgery