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Erschienen in: Surgery Today 5/2021

17.09.2020 | Original Article

Indications for laparoscopic surgery for older rectal cancer patients with comorbidities

verfasst von: Yuichi Hisamatsu, Naotaka Kuriyama, Yoshiaki Fujimoto, Tomoko Jogo, Qingjiang Hu, Kentaro Hokonohara, Ryota Nakanishi, Koji Ando, Yasue Kimura, Eiji Oki, Masaki Mori

Erschienen in: Surgery Today | Ausgabe 5/2021

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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.
Literatur
1.
Zurück zum Zitat Péron J, Bylicki O, Laude C, Martel-Lafay I, Carrie C, Racadot S. Nonoperative management of squamous-cell carcinoma of the rectum. Dis Colon Rectum. 2015;58:60–4.CrossRef Péron J, Bylicki O, Laude C, Martel-Lafay I, Carrie C, Racadot S. Nonoperative management of squamous-cell carcinoma of the rectum. Dis Colon Rectum. 2015;58:60–4.CrossRef
2.
Zurück zum Zitat Jeong BG, Kim DY, Kim SY. Concurrent chemoradiotherapy for squamous cell carcinoma of the rectum. Hepatogastroenterology. 2013;60:512–6.PubMed Jeong BG, Kim DY, Kim SY. Concurrent chemoradiotherapy for squamous cell carcinoma of the rectum. Hepatogastroenterology. 2013;60:512–6.PubMed
3.
Zurück zum Zitat Nagpal K, Bennett N. Colorectal surgery and its impact on male sexual function. Curr Urol Rep. 2013;14:279–84.CrossRef Nagpal K, Bennett N. Colorectal surgery and its impact on male sexual function. Curr Urol Rep. 2013;14:279–84.CrossRef
4.
Zurück zum Zitat Frasson M, Braga M, Vignali A, Zuliani W, Di Carlo V. Benefits of laparoscopic colorectal resection are more pronounced in elderly patients. Dis Colon Rectum. 2008;51:296–300.CrossRef Frasson M, Braga M, Vignali A, Zuliani W, Di Carlo V. Benefits of laparoscopic colorectal resection are more pronounced in elderly patients. Dis Colon Rectum. 2008;51:296–300.CrossRef
5.
Zurück zum Zitat Tomimaru Y, Ide Y, Murata K. Outcome of laparoscopic surgery for colon cancer in elderly patients. Asian J Endosc Surg. 2011;4:1–6.CrossRef Tomimaru Y, Ide Y, Murata K. Outcome of laparoscopic surgery for colon cancer in elderly patients. Asian J Endosc Surg. 2011;4:1–6.CrossRef
6.
Zurück zum Zitat Senagore AJ, Madbouly KM, Fazio VW, Duepree HJ, Brady KM, Delaney CP. Advantages of laparoscopic colectomy in older patients. Arch Surg. 2003;138:252–6.CrossRef Senagore AJ, Madbouly KM, Fazio VW, Duepree HJ, Brady KM, Delaney CP. Advantages of laparoscopic colectomy in older patients. Arch Surg. 2003;138:252–6.CrossRef
7.
Zurück zum Zitat Buunen M, Veldkamp R, Hop WC, Kuhry E, Jeekel J, Haglind E, et al. Survival after laparoscopic surgery versus open surgery for colon cancer: long-term outcome of a randomised clinical trial. Lancet Oncol. 2009;10:44–52.CrossRef Buunen M, Veldkamp R, Hop WC, Kuhry E, Jeekel J, Haglind E, et al. Survival after laparoscopic surgery versus open surgery for colon cancer: long-term outcome of a randomised clinical trial. Lancet Oncol. 2009;10:44–52.CrossRef
8.
Zurück zum Zitat Hemandas AK, Abdelrahman T, Flashman KG, Skull AJ, Senapati A, O'Leary DP, et al. Laparoscopic colorectal surgery produces better outcomes for high risk cancer patients compared to open surgery. Ann Surg. 2010;252:84–9.CrossRef Hemandas AK, Abdelrahman T, Flashman KG, Skull AJ, Senapati A, O'Leary DP, et al. Laparoscopic colorectal surgery produces better outcomes for high risk cancer patients compared to open surgery. Ann Surg. 2010;252:84–9.CrossRef
9.
Zurück zum Zitat Bagshaw PF, Allardyce RA, Frampton CM, Frizelle FA, Hewett PJ, McMurrick JP, et al. Long-term outcomes of the Australasian randomized clinical trial comparing laparoscopic and conventional open surgical treatments for colon cancer: the Australasian laparoscopic colon cancer study trial. Ann Surg. 2012;256:915–9.CrossRef Bagshaw PF, Allardyce RA, Frampton CM, Frizelle FA, Hewett PJ, McMurrick JP, et al. Long-term outcomes of the Australasian randomized clinical trial comparing laparoscopic and conventional open surgical treatments for colon cancer: the Australasian laparoscopic colon cancer study trial. Ann Surg. 2012;256:915–9.CrossRef
10.
Zurück zum Zitat Onodera T, Goseki N, Nosaki G. Prognostic nutritional index in gastrointestinal surgery of malnourished cancer patients. Nihon Geka Gakkai Zasshi. 1984;85(9):1001–5.PubMed Onodera T, Goseki N, Nosaki G. Prognostic nutritional index in gastrointestinal surgery of malnourished cancer patients. Nihon Geka Gakkai Zasshi. 1984;85(9):1001–5.PubMed
11.
Zurück zum Zitat Ignacio de Ulibarri J, Gonzalez-Madrono A, de Villar NG, Gonzalez P, Gonzalez B, Mancha A, et al. CONUT: a tool for controlling nutritional status. First validation in a hospital population. Nutr Hosp. 2005;20(1):38–45.PubMed Ignacio de Ulibarri J, Gonzalez-Madrono A, de Villar NG, Gonzalez P, Gonzalez B, Mancha A, et al. CONUT: a tool for controlling nutritional status. First validation in a hospital population. Nutr Hosp. 2005;20(1):38–45.PubMed
12.
Zurück zum Zitat Nakamura T, Sato T, Miura H, Ikeda A, Tsutsui A, Naito M, et al. Feasibility and outcomes of surgical therapy in very elderly patients with colorectal cancer. Surg Laparosc Endosc Percutan Tech. 2014;24(1):85–8.CrossRef Nakamura T, Sato T, Miura H, Ikeda A, Tsutsui A, Naito M, et al. Feasibility and outcomes of surgical therapy in very elderly patients with colorectal cancer. Surg Laparosc Endosc Percutan Tech. 2014;24(1):85–8.CrossRef
13.
Zurück zum Zitat Newcomb P, Carbone P. Cancer treatment and age: patient perspectives. J Natl Cancer Inst. 1993;85(19):1580–4.CrossRef Newcomb P, Carbone P. Cancer treatment and age: patient perspectives. J Natl Cancer Inst. 1993;85(19):1580–4.CrossRef
14.
Zurück zum Zitat Cone MM, Herzig DO, Diggs BS, Dolan JP, Rea JD, Deveney KE, et al. Dramatic decreases in mortality from laparoscopic colon resections based on data from the nationwide inpatient sample. Arch Surg. 2011;146(5):594–9.CrossRef Cone MM, Herzig DO, Diggs BS, Dolan JP, Rea JD, Deveney KE, et al. Dramatic decreases in mortality from laparoscopic colon resections based on data from the nationwide inpatient sample. Arch Surg. 2011;146(5):594–9.CrossRef
15.
Zurück zum Zitat Webb S, Rubinfeld I, Velanovich V, Horst HM, Reickert C. Using national surgical quality improvement program (NSQIP) data for risk adjustment to compare Clavien 4 and 5 complications in open and laparoscopic colectomy. Surg Endosc. 2012;26(3):732–7.CrossRef Webb S, Rubinfeld I, Velanovich V, Horst HM, Reickert C. Using national surgical quality improvement program (NSQIP) data for risk adjustment to compare Clavien 4 and 5 complications in open and laparoscopic colectomy. Surg Endosc. 2012;26(3):732–7.CrossRef
16.
Zurück zum Zitat Stefanou AJ, Reickert CA, Velanovich V, Falvo A, Rubinfeld I. Laparoscopic colectomy significantly decreases length of stay compared with open operation. Surg Endosc. 2012;26(1):144–8.CrossRef Stefanou AJ, Reickert CA, Velanovich V, Falvo A, Rubinfeld I. Laparoscopic colectomy significantly decreases length of stay compared with open operation. Surg Endosc. 2012;26(1):144–8.CrossRef
17.
Zurück zum Zitat Vaid S, Tucker J, Bell T, Grim R, Ahuja V. Cost analysis of laparoscopic versus open colectomy in patients with colon cancer: results from a large nationwide population database. Am Surg. 2012;78(6):635–41.CrossRef Vaid S, Tucker J, Bell T, Grim R, Ahuja V. Cost analysis of laparoscopic versus open colectomy in patients with colon cancer: results from a large nationwide population database. Am Surg. 2012;78(6):635–41.CrossRef
18.
Zurück zum Zitat Kuroyanagi H, Inomata M, Saida Y, Hasegawa S, Funayama Y, Yamamoto S, et al. Gastroenterological surgery: large intestine. Asian J Endosc Surg. 2015;8(3):246–62.CrossRef Kuroyanagi H, Inomata M, Saida Y, Hasegawa S, Funayama Y, Yamamoto S, et al. Gastroenterological surgery: large intestine. Asian J Endosc Surg. 2015;8(3):246–62.CrossRef
19.
Zurück zum Zitat Hinoi T, Kawaguchi Y, Hattori M, Okajima M, Ohdan H, Yamamoto S, Hasegawa H, Horie H, Murata K, Yamaguchi S, Sugihara K, Watanabe M, Japan Society of Laparoscopic Colorectal Surgery. Laparoscopic versus open surgery for colorectal cancer in elderly patients: a multicenter matched case-control study. Ann Surg Oncol. 2015;22(6):2040–50.CrossRef Hinoi T, Kawaguchi Y, Hattori M, Okajima M, Ohdan H, Yamamoto S, Hasegawa H, Horie H, Murata K, Yamaguchi S, Sugihara K, Watanabe M, Japan Society of Laparoscopic Colorectal Surgery. Laparoscopic versus open surgery for colorectal cancer in elderly patients: a multicenter matched case-control study. Ann Surg Oncol. 2015;22(6):2040–50.CrossRef
Metadaten
Titel
Indications for laparoscopic surgery for older rectal cancer patients with comorbidities
verfasst von
Yuichi Hisamatsu
Naotaka Kuriyama
Yoshiaki Fujimoto
Tomoko Jogo
Qingjiang Hu
Kentaro Hokonohara
Ryota Nakanishi
Koji Ando
Yasue Kimura
Eiji Oki
Masaki Mori
Publikationsdatum
17.09.2020
Verlag
Springer Singapore
Erschienen in
Surgery Today / Ausgabe 5/2021
Print ISSN: 0941-1291
Elektronische ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-020-02140-1

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