Laparoscopy-assisted versus open colectomy for treatment of colon cancer in the elderly: morbidity and mortality outcomes in 545 patients
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- 作者：Francesc Vallribera Valls (1) (2)
Filippo Landi (1) (2)
Eloy Espín Basany (1) (2)
José Luis Sánchez García (1) (2)
Luis Miguel Jiménez Gómez (1)
Marc Martí Gallostra (1)
Luis Salgado Cruz (1)
Manuel Armengol Carrasco (1) (2) - 关键词：Elderly patients ; Colon cancer ; Laparoscopy ; assisted versus open colectomy ; Morbidity and mortality
- 刊名：Surgical Endoscopy
- 出版年：2014
- 出版时间：December 2014
- 年：2014
- 卷：28
- 期：12
- 页码：3373-3378
- 全文大小：235 KB
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Filippo Landi (1) (2)
Eloy Espín Basany (1) (2)
José Luis Sánchez García (1) (2)
Luis Miguel Jiménez Gómez (1)
Marc Martí Gallostra (1)
Luis Salgado Cruz (1)
Manuel Armengol Carrasco (1) (2)
1. Unit of Colorectal Surgery, General and Digestive Surgery Department, Hospital Universitario Vall d’Hebron, Passeig Vall d’Hebron 119-129, 08035, Barcelona, Spain
2. Universidad Autonoma de Barcelona, Barcelona, Spain - ISSN：1432-2218
文摘
Background Advanced age is a risk factor of major abdominal surgery due to diminished functional reserve and increased comorbidity. Laparoscopy-assisted colectomy is a well-established procedure in colon cancer surgery. The aim of this study was to compare early outcome of elective laparoscopy surgery and open colectomy in colon cancer patients according to age. Methods A total of 545 patients with colonic adenocarcinoma underwent elective surgery between 2005 and 2009. There were 277 patients in the laparoscopic group and 268 in the open. Patient characteristics in both groups were homogeneous and further stratified into three subgroups by age: Results Open surgery group showed a higher overall morbidity rate (37.3 vs. 21.6?%, P?=?0.001), medical complications (16.4 vs. 10.5?%, P?=?0.033), surgical complications (23.5 vs. 15.5?%, P?=?0.034), and mortality (6.7 vs. 3.2?%, P?=?0.034). The overall morbidity rate difference between open and laparoscopy approach disappeared in the oldest group (?5?years old). Surgical site infections rate was inferior for patients P?=?0.038). Mean hospital stay was shorter for patients in P?=?0.001) as compared with those who underwent open surgery, but these differences disappeared in patients aged ?5?years. Conclusion Laparoscopy-assisted colectomy in patients underwent elective surgical resections for colon cancer showed advantages in rate of early complications in patients younger than 85?years of age and was found to be as safe and well tolerated as open surgery in patients over 85?years of age.