Outcome of laparoscopic surgery for colon cancer in elderly patients


Kohei Murata, Department of Surgery, Suita Municipal Hospital, 2-13-20, Katayama-cho, Suita, Osaka 564-0082, Japan. Tel: +81 6 6387 3311
Fax: +81 6 6380 5825
Email: colon@mhp.suita.osaka.jp


Introduction: The aim of this study was to evaluate whether elderly patients with colorectal cancer benefit from laparoscopic colon surgery (LAC) in comparison to open colon surgery (OC).

Methods: Patients with colon cancer were divided into four groups; >75 years (CC>75) [LAC>75 (n=36), OC>75 (n=15)] and ≤75 years [LAC≤75 (n=90), OC≤75 (n=26)]. Differences in postoperative short-term outcomes were analyzed among the age and procedure groups.

Results: Intraoperative blood loss was significantly less in the LAC>75 group (68 ± 168 ml) than in the OC>75 group (118 ± 130 ml, P=0.040). The C-reactive protein of patients in the OC>75 group (5.4 ± 2.2 mg/dl) tended to be less than that of the LAC>75 group (6.1 ± 2.8 mg/dl, P=0.080) on postoperative day 1. The time to the first passage of flatus was significantly shorter in the LAC>75 group (2.0 ± 0.7 days) than in the OC>75 group (2.7 ± 0.8 days, P=0.003). Postoperative hospital stays were also shorter in the LAC>75 group (14.2 ± 9.4 days) than in the OC>75 group (18.0 ± 8.3 days, P=0.038). No mortality was registered in the LAC>75 group, while one patient in the OC>75 group died during the postoperative course. The rate of postoperative morbidity was similar between the LAC>75 and OC>75 groups [13.9% (5/36) versus 20.0% (3/15), P=0.679].

Conclusion: LAC provides some advantages over OC in patients with colon cancer aged >75 years as well as in those aged ≤75 years. LAC can be safely performed in very elderly patients with colon cancer.