Laparoscopy-assisted versus open colectomy for treatment of colon cancer in the elderly: morbidity and mortality outcomes in 545 patients

被引:62
作者
Vallribera Valls, Francesc [1 ,2 ]
Landi, Filippo [1 ,2 ]
Espin Basany, Eloy [1 ,2 ]
Sanchez Garcia, Jose Luis [1 ,2 ]
Jimenez Gomez, Luis Miguel [1 ]
Marti Gallostra, Marc [1 ]
Salgado Cruz, Luis [1 ]
Armengol Carrasco, Manuel [1 ,2 ]
机构
[1] Hosp Univ Vall dHebron, Gen & Digest Surg Dept, Unit Colorectal Surg, Barcelona 08035, Spain
[2] Univ Autonoma Barcelona, E-08193 Barcelona, Spain
来源
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES | 2014年 / 28卷 / 12期
关键词
Elderly patients; Colon cancer; Laparoscopy-assisted versus open colectomy; Morbidity and mortality; RANDOMIZED CLINICAL-TRIAL; ADJUVANT CHEMOTHERAPY; OPEN SURGERY; SURVIVAL; RESECTION;
D O I
10.1007/s00464-014-3597-4
中图分类号
R61 [外科手术学];
学科分类号
摘要
Advanced age is a risk factor of major abdominal surgery due to diminished functional reserve and increased comorbidity. Laparoscopy-assisted colectomy is a well-established procedure in colon cancer surgery. The aim of this study was to compare early outcome of elective laparoscopy surgery and open colectomy in colon cancer patients according to age. A total of 545 patients with colonic adenocarcinoma underwent elective surgery between 2005 and 2009. There were 277 patients in the laparoscopic group and 268 in the open. Patient characteristics in both groups were homogeneous and further stratified into three subgroups by age: < 75, between 75-84, and a parts per thousand yen85 years. Main outcome measures were early morbidity, mortality, and hospital stay. Open surgery group showed a higher overall morbidity rate (37.3 vs. 21.6 %, P = 0.001), medical complications (16.4 vs. 10.5 %, P = 0.033), surgical complications (23.5 vs. 15.5 %, P = 0.034), and mortality (6.7 vs. 3.2 %, P = 0.034). The overall morbidity rate difference between open and laparoscopy approach disappeared in the oldest group (a parts per thousand yen85 years old). Surgical site infections rate was inferior for patients < 75 years old in laparoscopy group compared with open. Mortality was also significantly inferior in laparoscopy group in younger patients (< 75 years, 0 vs. 3 %, P = 0.038). Mean hospital stay was shorter for patients in < 75 and 75-84 groups with laparoscopic approach (7.8 vs. 11.4 days and 10 vs. 14.3, respectively, P = 0.001) as compared with those who underwent open surgery, but these differences disappeared in patients aged a parts per thousand yen85 years. Laparoscopy-assisted colectomy in patients underwent elective surgical resections for colon cancer showed advantages in rate of early complications in patients younger than 85 years of age and was found to be as safe and well tolerated as open surgery in patients over 85 years of age.
引用
收藏
页码:3373 / 3378
页数:6
相关论文
共 24 条
[1]  
Ades S, 2009, ONCOLOGY-NY, V23, P162
[2]  
[Anonymous], 2002, AJCC CANC STAGING HD
[3]  
Bonjer HJ, 2009, LANCET ONCOL, V10, P44, DOI 10.1016/S1470-2045(08)70310-3
[4]   Laparoscopic surgery versus open surgery for colon cancer:: short-term outcomes of a randomised trial [J].
Bonjer, HJ ;
Haglind, E ;
Jeekel, I ;
Kazemier, G ;
Páhlman, L ;
Hop, WCJ ;
Veldkamp, R ;
Kuhry, E ;
Haglind, E ;
Pahlman, L ;
Cuesta, MA ;
Msika, S ;
Morino, M ;
Lacy, A ;
Jeekel, I .
LANCET ONCOLOGY, 2005, 6 (07) :477-484
[5]  
COPELAND GP, 1991, BRIT J SURG, V78, P356
[6]   COLOR - A randomized clinical trial comparing laparoscopic and open resection for colon cancer [J].
Hazebroek, EJ .
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 2002, 16 (06) :949-953
[7]   Outcome of Colonic Surgery in Elderly Patients with Colon Cancer [J].
Hermans, E. ;
van Schaik, P. M. ;
Prins, H. A. ;
Ernst, M. F. ;
Dautzenberg, P. J. L. ;
Bosscha, K. .
JOURNAL OF ONCOLOGY, 2010, 2010
[8]   Laparoscopic colectomy for colon adenocarcinoma - An 11-year retrospective review with 5-year survival rates [J].
Jacob, BP ;
Salky, B .
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 2005, 19 (05) :643-649
[9]   Optimizing Surgical Care of Colon Cancer in the Older Adult Population [J].
Kennedy, Gregory D. ;
Rajamanickam, Victoria ;
O'Connor, Erin S. ;
Loconte, Noelle K. ;
Foley, Eugene F. ;
Leverson, Glen ;
Heise, Charles P. .
ANNALS OF SURGERY, 2011, 253 (03) :508-514
[10]   Long-term results of laparoscopic colorectal cancer resection [J].
Kuhry, E. ;
Schwenk, W. F. ;
Gaupset, R. ;
Romild, U. ;
Bonjer, H. J. .
COCHRANE DATABASE OF SYSTEMATIC REVIEWS, 2008, (02)