Laparoscopic Colorectal Surgery in the Elderly

Viewpoints from Steven Wexner, MD

The age of our population continues to increase. Since the introduction of laparoscopic colorectal surgery in 1991, the indications and results have been continually scrutinized. Thus far, there is a dearth of literature regarding the application of this technology in octogenarians.

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What does data actually say?

In order to to help clarify this issue, Roscio and associates evaluated 96 patients over age 80 with colon cancer and 33 patients over age 80 with rectal cancer.

These groups were compared to 220 patients between ages 60 and 69 years with colon cancer and 82 patients between ages 60 and 69 years with rectal cancer. There was no significant difference in operative time, estimated blood loss, conversion rate, resolution of ileus, length of hospitalization or rates of readmission. Very importantly, there was no difference in morbidity between the two age groups.

Study confirms our experience

This study lends clear support to the fact that advanced age should not be a contraindication to the performance of laparoscopic colorectal surgery for colon or rectal cancer.

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As always, it is gratifying to have one’s own personal findings confirmed. We have routinely employed laparoscopic colorectal surgery to the octogenarian and nonagenarian population. I am delighted that Roscio and associates reported similar findings to those which we have noted in our practice at Cleveland Clinic Florida.

References:

  1. Lee, SH., Lakhtaria, P., Canedo, J. et al. Outcome of laparoscopic rectopexy versus perineal rectosigmoidectomy for full-thickness rectal prolapse in elderly patients. Surg Endosc (2011) 25: 2699.
  2. Person, B., Cera, S.M., Sands, D.R. et al. Do elderly patients benefit from laparoscopic colorectal surgery? Surg Endosc (2008) 22: 401–405.