Postoperative complications in elderly patients with colorectal cancer: Comparison of open and laparoscopic surgical procedures

Mitsuyoshi Tei, Masataka Ikeda, Naotsugu Haraguchi, Ichiro Takemasa, Tsunekazu Mizushima, Hideshi Ishii, Hirofumi Yamamoto, Mitsugu Sekimoto, Yuichiro Doki, Masaki Mori

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19 Citations (Scopus)

Abstract

Background: Surgery is associated with higher morbidity and mortality rates in elderly patients with colorectal cancer compared with younger patients. The aim of this study was to examine preoperative evaluation for selecting operative procedure in elderly patients with colorectal cancer. Methodsin: The study of all patients who underwent open surgery (OS) or laparoscopically assisted surgery (LAS) for colorectal cancer from January 2004 to December 2007 were aged ≥71 years. Preoperative evaluation, operative factors, morbidity, and mortality were analyzed by the Physiological and Operative Severity Score for Enumeration of Mortality and Morbidity (POSSUM) and Prognostic Nutritional Index (PNI). Results: A total of 129 patients were included in this study. Fifty-one patients underwent OS, and LAS was performed on 78 patients. The morbidity rate was 51.3% (40 patients) for the OS group and 23.5% (12 patients) for the LAS group. Three LAS patients (5.9%) subsequently required OS. One LAS patient died postoperatively. There were significant differences in the Operative Severity Score (OSS) in POSSUM and PNI, but not Physiologic Score (PS) in POSSUM, between the two groups. In the OS group, there were significant differences in PS, OSS, and PNI between those with or without complications, whereas in the LAS group, OSS, but not PS or PNI, was significantly lower in those without than in those with complications. Conclusions: Compared with OS, LAS is associated with a lower incidence of complications in elderly patients with colorectal cancer. The nutritional status correlated with postoperative complications in the OS group.

Original languageEnglish
Pages (from-to)488-492
Number of pages5
JournalSurgical Laparoscopy, Endoscopy and Percutaneous Techniques
Volume19
Issue number6
DOIs
Publication statusPublished - Dec 1 2009
Externally publishedYes

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Laparoscopy
Colorectal Neoplasms
Nutrition Assessment
Morbidity
Mortality
Operative Surgical Procedures
Nutritional Status

All Science Journal Classification (ASJC) codes

  • Surgery

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Postoperative complications in elderly patients with colorectal cancer : Comparison of open and laparoscopic surgical procedures. / Tei, Mitsuyoshi; Ikeda, Masataka; Haraguchi, Naotsugu; Takemasa, Ichiro; Mizushima, Tsunekazu; Ishii, Hideshi; Yamamoto, Hirofumi; Sekimoto, Mitsugu; Doki, Yuichiro; Mori, Masaki.

In: Surgical Laparoscopy, Endoscopy and Percutaneous Techniques, Vol. 19, No. 6, 01.12.2009, p. 488-492.

Research output: Contribution to journalArticle

Tei, Mitsuyoshi ; Ikeda, Masataka ; Haraguchi, Naotsugu ; Takemasa, Ichiro ; Mizushima, Tsunekazu ; Ishii, Hideshi ; Yamamoto, Hirofumi ; Sekimoto, Mitsugu ; Doki, Yuichiro ; Mori, Masaki. / Postoperative complications in elderly patients with colorectal cancer : Comparison of open and laparoscopic surgical procedures. In: Surgical Laparoscopy, Endoscopy and Percutaneous Techniques. 2009 ; Vol. 19, No. 6. pp. 488-492.
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abstract = "Background: Surgery is associated with higher morbidity and mortality rates in elderly patients with colorectal cancer compared with younger patients. The aim of this study was to examine preoperative evaluation for selecting operative procedure in elderly patients with colorectal cancer. Methodsin: The study of all patients who underwent open surgery (OS) or laparoscopically assisted surgery (LAS) for colorectal cancer from January 2004 to December 2007 were aged ≥71 years. Preoperative evaluation, operative factors, morbidity, and mortality were analyzed by the Physiological and Operative Severity Score for Enumeration of Mortality and Morbidity (POSSUM) and Prognostic Nutritional Index (PNI). Results: A total of 129 patients were included in this study. Fifty-one patients underwent OS, and LAS was performed on 78 patients. The morbidity rate was 51.3{\%} (40 patients) for the OS group and 23.5{\%} (12 patients) for the LAS group. Three LAS patients (5.9{\%}) subsequently required OS. One LAS patient died postoperatively. There were significant differences in the Operative Severity Score (OSS) in POSSUM and PNI, but not Physiologic Score (PS) in POSSUM, between the two groups. In the OS group, there were significant differences in PS, OSS, and PNI between those with or without complications, whereas in the LAS group, OSS, but not PS or PNI, was significantly lower in those without than in those with complications. Conclusions: Compared with OS, LAS is associated with a lower incidence of complications in elderly patients with colorectal cancer. The nutritional status correlated with postoperative complications in the OS group.",
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T1 - Postoperative complications in elderly patients with colorectal cancer

T2 - Comparison of open and laparoscopic surgical procedures

AU - Tei, Mitsuyoshi

AU - Ikeda, Masataka

AU - Haraguchi, Naotsugu

AU - Takemasa, Ichiro

AU - Mizushima, Tsunekazu

AU - Ishii, Hideshi

AU - Yamamoto, Hirofumi

AU - Sekimoto, Mitsugu

AU - Doki, Yuichiro

AU - Mori, Masaki

PY - 2009/12/1

Y1 - 2009/12/1

N2 - Background: Surgery is associated with higher morbidity and mortality rates in elderly patients with colorectal cancer compared with younger patients. The aim of this study was to examine preoperative evaluation for selecting operative procedure in elderly patients with colorectal cancer. Methodsin: The study of all patients who underwent open surgery (OS) or laparoscopically assisted surgery (LAS) for colorectal cancer from January 2004 to December 2007 were aged ≥71 years. Preoperative evaluation, operative factors, morbidity, and mortality were analyzed by the Physiological and Operative Severity Score for Enumeration of Mortality and Morbidity (POSSUM) and Prognostic Nutritional Index (PNI). Results: A total of 129 patients were included in this study. Fifty-one patients underwent OS, and LAS was performed on 78 patients. The morbidity rate was 51.3% (40 patients) for the OS group and 23.5% (12 patients) for the LAS group. Three LAS patients (5.9%) subsequently required OS. One LAS patient died postoperatively. There were significant differences in the Operative Severity Score (OSS) in POSSUM and PNI, but not Physiologic Score (PS) in POSSUM, between the two groups. In the OS group, there were significant differences in PS, OSS, and PNI between those with or without complications, whereas in the LAS group, OSS, but not PS or PNI, was significantly lower in those without than in those with complications. Conclusions: Compared with OS, LAS is associated with a lower incidence of complications in elderly patients with colorectal cancer. The nutritional status correlated with postoperative complications in the OS group.

AB - Background: Surgery is associated with higher morbidity and mortality rates in elderly patients with colorectal cancer compared with younger patients. The aim of this study was to examine preoperative evaluation for selecting operative procedure in elderly patients with colorectal cancer. Methodsin: The study of all patients who underwent open surgery (OS) or laparoscopically assisted surgery (LAS) for colorectal cancer from January 2004 to December 2007 were aged ≥71 years. Preoperative evaluation, operative factors, morbidity, and mortality were analyzed by the Physiological and Operative Severity Score for Enumeration of Mortality and Morbidity (POSSUM) and Prognostic Nutritional Index (PNI). Results: A total of 129 patients were included in this study. Fifty-one patients underwent OS, and LAS was performed on 78 patients. The morbidity rate was 51.3% (40 patients) for the OS group and 23.5% (12 patients) for the LAS group. Three LAS patients (5.9%) subsequently required OS. One LAS patient died postoperatively. There were significant differences in the Operative Severity Score (OSS) in POSSUM and PNI, but not Physiologic Score (PS) in POSSUM, between the two groups. In the OS group, there were significant differences in PS, OSS, and PNI between those with or without complications, whereas in the LAS group, OSS, but not PS or PNI, was significantly lower in those without than in those with complications. Conclusions: Compared with OS, LAS is associated with a lower incidence of complications in elderly patients with colorectal cancer. The nutritional status correlated with postoperative complications in the OS group.

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