Flynn David E, Mao Derek, Yerkovich Stephanie, Franz Robert, Iswariah Harish, Hughes Andrew, Shaw Ian, Tam Diana, Chandrasegaram Manju
Department of General Surgery, The Prince Charles Hospital, Chermside 4032, Queensland, Australia.
Department of General Surgery, The Prince Charles Hospital, Brisbane 4032, Queensland, Australia.
World J Gastrointest Oncol. 2021 Mar 15;13(3):185-196. doi: 10.4251/wjgo.v13.i3.185.
The prevalence of colorectal cancer in the elderly is rising, with increasing numbers of older patients undergoing surgery. However, there is a paucity of information on the surgical outcomes and operative techniques used in this population.
To evaluate the post-operative outcomes for patients ≥ 85 years old following colorectal cancer resection as well as evaluating the outcomes of laparoscopic resection of colorectal cancer in patients over 85.
Patients who underwent colorectal cancer resection at our institution between January 2010 and December 2018 were included. The study was divided into two parts. For part one, patients were divided into two groups based on age: Those age ≥ 85 years old ( = 48) and those aged 75-84 years old ( = 136). Short term surgical outcomes and clinicopathological features were compared using appropriate parametric and non-parametric testing. For part two, patient's over 85 years old were divided into two groups based upon operative technique: Laparoscopic ( = 37) open ( = 11) colorectal resection. Short-term post-operative outcomes of each approach were assessed.
The median length of stay between patients over 85 and those aged 75-85 was eight days, with no statistically significant difference between the groups ( = 0.29). No significant difference was identified between the older and younger groups with regards to severity of complications ( = 0.93), American Society of Anaesthesiologists grading ( = 0.43) or 30-d mortality (2% 2%, = 0.96). Patients over 85 who underwent laparoscopic colorectal resection were compared to those who underwent an open resection. The median length of stay between the groups was similar (8 9 d respectively) with no significant difference in length of stay ( = 0.18). There was no significant difference in 30-d mortality rates (0% 9%, = 0.063) or severity of complication grades ( = 0.46) between the laparoscopic and open surgical groups.
No significant short term surgical differences were identified in patients ≥ 85 years old when compared to those 75-85 years old. There is no difference in short term surgical outcomes between laparoscopic or open colorectal resections in patients over 85.
老年人大肠癌的患病率正在上升，接受手术的老年患者数量也在增加。然而，关于该人群手术结果和手术技术的信息却很匮乏。
评估85岁及以上患者结直肠癌切除术后的手术结果，并评估85岁以上患者腹腔镜结直肠癌切除术的结果。
纳入2010年1月至2018年12月在我院接受结直肠癌切除术的患者。该研究分为两部分。第一部分，根据年龄将患者分为两组：年龄≥85岁（n = 48）和年龄75 - 84岁（n = 136）。使用适当的参数和非参数检验比较短期手术结果和临床病理特征。第二部分，85岁以上的患者根据手术技术分为两组：腹腔镜手术（n = 37）和开放手术（n = 11）切除结直肠癌。评估每种手术方式的短期术后结果。
85岁以上患者与75 - 85岁患者的中位住院时间均为8天，两组之间无统计学显著差异（P = 0.29）。在并发症严重程度（P = 0.93）、美国麻醉医师协会分级（P = 0.43）或30天死亡率（2%对2%，P = 0.96）方面，老年组和年轻组之间未发现显著差异。对85岁以上接受腹腔镜结直肠癌切除术的患者与接受开放切除术的患者进行比较。两组之间的中位住院时间相似（分别为8天对9天），住院时间无显著差异（P = 0.18）。腹腔镜手术组和开放手术组之间的30天死亡率（0%对9%，P = 0.063）或并发症严重程度分级（P = 0.46）无显著差异。
与75 - 85岁的患者相比，85岁及以上患者在短期手术方面未发现显著差异。85岁以上患者腹腔镜或开放结直肠癌切除术的短期手术结果无差异。
