Clinical benefits of single-incision laparoscopic surgery for postoperative delirium in elderly colon cancer patients.

Nishizawa, Yujiro; Hata, Taishi; Takemasa, Ichiro; Yamasaki, Makoto; Akasaka, Hiroshi; Sugimoto, Ken; Tamai, Koki; Takahashi, Hidekazu; Haraguchi, Naotsugu; Nishimura, Junichi; Matsuda, Chu; Mizushima, Tsunekazu; Ikenaga, Masakazu; Yamamoto, Hirofumi; Murata, Kohei; Rakugi, Hiromi; Doki, Yuichiro; Mori, Masaki

BACKGROUND The number of elderly patients with colon cancer is increasing in Japan. Postoperative delirium (POD) is a major complication for elderly patients who undergo surgery, and postoperative pain is a common inducer of POD. We reported previously that single-incision laparoscopic surgery (SLS) significantly reduces postoperative pain compared to conventional laparoscopic surgery (CLS). Data are lacking about the effect of SLS on POD. This retrospective study evaluated the clinical benefits of SLS for POD in elderly patients with colon cancer. METHODS This retrospective case-control study included colon cancer patients (n = 134) over 75 years old who underwent elective surgery from 2009 to 2015 at Osaka University Hospital. Of these patients, 110 were evaluated using the comprehensive geriatric assessment (CGA) before surgery and were classified into lower or higher risk groups based on their scores. RESULTS The rate of POD was significantly lower in the SLS group than the CLS group (13.8% vs. 30.0%; p = 0.0161). In the CGA-based higher risk group, the rate of POD was significantly higher in the CLS group than the SLS group (p = 0.0153). CONCLUSIONS SLS for elderly colon cancer patients may lower the incidence of POD compared with CLS.