Indications for laparoscopic surgery for older rectal cancer patients with comorbidities

Surg Today. 2021 May;51(5):721-726. doi: 10.1007/s00595-020-02140-1. Epub 2020 Sep 17.

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.

Keywords: Comorbidities; Laparoscopic surgery; Older patients; Rectal cancer.

MeSH terms

  • Age Factors
  • Aged, 80 and over
  • Comorbidity
  • Digestive System Surgical Procedures / methods*
  • Eating
  • Female
  • Heart Diseases / epidemiology
  • Humans
  • Laparoscopy / methods*
  • Length of Stay
  • Male
  • Nutritional Status
  • Postoperative Complications / epidemiology
  • Rectal Neoplasms / epidemiology
  • Rectal Neoplasms / surgery*
  • Safety
  • Time Factors
  • Treatment Outcome