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Outcome of laparoscopic versus openresection for rectal cancer in elderly patients Wei-gen Zeng, MD,a Zhi-xiang Zhou, MD,a,*Hui-rong Hou, MD,b Jian-wei Liang, MD,a Hai-tao Zhou, MD,a Zheng Wang, MD,a Xing-maoZhang, MD,a and Jun-jie Hu, MDa a Department of Colorectal Surgery, CancerHospital, Chinese Academy of Medical Sciences, Peking Union Medical College,Chaoyang District, Beijing, China b The Overall Planning Office, CancerHospital, Chinese Academy of Medical Sciences, Peking Union Medical College, ChaoyangDistrict, Beijing, China Background: Laparoscopic colorectalresection has been gaining popularity over the past two decades. However,studies about laparoscopic rectal surgery in elderly patients with longterm oncologicoutcomes are limited. In this study, we evaluated the short-term and longterm outcomesof laparoscopic and open resection in patients with rectal cancer aged 70 y. Methods: From 2007e2012, a total of 294consecutive patients with rectal cancer from a single institution wereincluded, 112 patients undergoing laparoscopic rectal resection were comparedwith 182 patients undergoing open rectal resection. Results: Seven (6.3%) patients in thelaparoscopic group required conversion to open surgery. The two groups werewell balanced in terms of age, gender, body mass index, American society ofanesthesiologists scores, site, and stage of the tumors. Laparoscopic surgerywas associated with significantly longer median operating time (220 versus 200min; P ¼ 0.005), less estimated blood loss (100 versus 150 mL; P < 0.001), ashorter postoperative hospital stay (8 versus 11 d), lower overallpostoperative complication rate (15.2% versus 26.4%; P ¼ 0.025), wound-relatedcomplication rate (7.14% versus 17.03%; P ¼ 0.015), less need of bloodtransfusion (8.04% versus 16.5%; P ¼ 0.038), and surgical intensive care unitafter surgery (12.5% versus 22.0%; P ¼ 0.042) when compared with open surgery.Mortality, quality of surgical specimen, lymph nodes harvested, positivedistal, and circumferential margin rate were not significantly differentbetween two groups. The estimated 3-y survival rates were similar between twogroups. Conclusions: Laparoscopic rectal surgery issafe and feasible in patients >70 y and is associated with better short-term outcomes whencompared with open surgery. |
