Indications for laparoscopic surgery for older rectal cancer patients with comorbidities

Yuichi Hisamatsu, Naotaka Kuriyama, Yoshiaki Fujimoto, Tomoko Jogo, Qingjiang Hu, Kentaro Hokonohara, Ryota Nakanishi, Koji Ando, Yasue Kimura, Eiji Oki, Masaki Mori

Research output: Contribution to journalArticlepeer-review

Abstract

PURPOSE: Given the lack of safety studies concerning laparoscopic surgery for rectal cancer in patients ≥ 80 years old with comorbidities, we sought to investigate this in the current study.

METHODS: Between 2012 and 2019, 24 patients ≥ 80 years old underwent laparoscopic surgery for rectal cancer without preoperative treatment. These patients were divided into those with [comorbidity(+) group, n = 13] and without [comorbidity(-) group, n = 11] comorbidities. The preoperative nutritional status and ASA classification, postoperative complications, time to oral diet, and length of hospital stay were evaluated in each group.

RESULTS: In the comorbidity(+)/comorbidity(-) groups, the average age was 85.9/84.1 years old, respectively. The major comorbidities were heart disease including atrial fibrillation and valvular disorder. The average PNI and CONUT scores in the comorbidity(+)/comorbidity(-) groups were 44.7/44.2 an 3.1/2.2, respectively. Planned surgical procedures were completed in all patients. Postoperative complications occurred in 2/3 cases in the comorbidity(+)/comorbidity(-) groups, respectively, and the average time to oral diet was 3.8/3.7 days, while the average length of hospitalization after surgery was 15.2/16.5 days, respectively. In the comorbidity(+) group, there was no exacerbation of comorbidities in any cases.

CONCLUSION: The safety of laparoscopic surgery is acceptable among older rectal cancer patients with comorbidities.

Original languageEnglish
JournalSurgery today
DOIs
Publication statusE-pub ahead of print - Sep 17 2020

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