Outcomes of laparoscopic surgery for colorectal cancer in oldest-old patients.

Mukai, Toshiki; Akiyoshi, Takashi; Ueno, Masashi; Fukunaga, Yosuke; Nagayama, Satoshi; Fujimoto, Yoshiya; Konishi, Tsuyoshi; Ikeda, Atsushi; Yamaguchi, Toshiharu

BACKGROUND The effect of laparoscopic colorectal surgery in oldest-old patients (85 y or older) is unclear. This study aimed to evaluate the short-term outcomes of laparoscopic colorectal cancer surgery compared with open surgery in the oldest-old. METHODS Forty-four patients aged 85 years and older with colorectal cancer who underwent elective laparoscopic surgery (LAC group) were compared with 37 patients aged 85 years and older who underwent open surgery (OC group). RESULTS There were no significant differences in the age, the sex, the body mass index, and the American Society of Anesthesiologists grade between the groups. The comorbidity rate was slightly higher in the LAC group than in the OC group (68% vs. 57%). The mean operating time was significantly longer (209 vs. 194 min, P=0.014), but the mean estimated blood loss was significantly less (30 vs. 286 mL, P<0.001) in the LAC group than in the OC group. The mean time to flatus (1.7 vs. 3.9 d, P<0.0001), the time to liquid diet (2.7 vs. 7.7 d, P<0.0001), and the length of postoperative hospital stay (14.7 vs. 21.7 d, P<0.0001) were significantly shorter in the LAC group than in the OC group. The rate of postoperative complications tended to be lower in the LAC group than in the OC group (13.6% vs. 27%). CONCLUSIONS Laparoscopic surgery for colorectal cancer in oldest-old patients can be performed safely with better short-term outcomes compared with open surgery.