Abstract
Rationale, aims and objective The prevalence of colorectal cancer in the
elderly is increasing with older patients undergoing surgery. The aim of
the study was two-fold: 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. Methods The study was divided into two parts. For
part one, patients were divided into two groups based on age: those age
≥ 85 years old and those aged 75-84 years old. 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 vs open colorectal resection.
Short-term post-operative outcomes of each approach were assessed.
Results The median length of stay (LOS) between patients over 85 and
those aged 75-85 was eight days, with no statistically significant
difference in LOS between the groups (p=0.29). No significant difference
was identified between the older and younger groups with regards to
severity of complications (p=0.93), ASA grading (p=0.43) or 30-day
mortality (2 vs 2%, p= p=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 group was
similar (8 vs 9 days respectively) with no significant difference in
length of stay (p=0.18). There was no significant difference in 30-day
mortality rates (0% vs 9%, p=0.063) or severity of complication grades
(p=0.46) between the laparoscopic and open surgical groups. Conclusion
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.