Skip to main content
Erschienen in: Surgical Endoscopy 1/2013

01.01.2013 | Review

Laparoscopic versus open colorectal resection in the elderly population

verfasst von: Katherine Grailey, Sheraz R. Markar, Alan Karthikesalingam, Rima Aboud, Paul Ziprin, Omar Faiz

Erschienen in: Surgical Endoscopy | Ausgabe 1/2013

Einloggen, um Zugang zu erhalten

Abstract

Background

Elderly patients are often regarded as high-risk patients for major abdominal surgery because of a lack of functional reserve and associated medical comorbidities. The aim of this systematic review and pooled analysis was to review the current data published regarding the differences in operative outcomes of laparoscopic and open surgery in the elderly population.

Methods

A systematic literature search of Medline, Embase, Web of Science, and Cochrane databases was performed. Studies that compared outcome following laparoscopic and open colorectal resections in the elderly (≥70) population were included. Primary outcomes were operative death, anastomotic leak, pneumonia, length of hospital stay, and return to bowel function. Secondary outcomes were operative time, intraoperative blood loss, postoperative cardiac morbidity, ileus, and postoperative wound infection.

Results

The results of this systematic review and pooled analysis demonstrate the safety and potential benefits of laparoscopic colorectal resection in the elderly population. The latter include reduction in length of hospital stay, intraoperative blood loss, incidence of postoperative pneumonia, time to return of normal bowel function, incidence of postoperative cardiac complications, and wound infections.

Conclusion

The results of this pooled analysis demonstrate the potential short-term advantages of laparoscopic colorectal resection in the elderly population. Further studies are required to examine the long-term survival following laparoscopic and open colorectal resections in the elderly population.
Literatur
1.
Zurück zum Zitat Creditor M (1993) Hazards of hospitalization of the elderly. Ann Intern Med 118:219–223PubMed Creditor M (1993) Hazards of hospitalization of the elderly. Ann Intern Med 118:219–223PubMed
2.
Zurück zum Zitat Weber DM (2003) Laparoscopic surgery: an excellent approach in elderly patients. Arch Surg 138:1083–1088CrossRefPubMed Weber DM (2003) Laparoscopic surgery: an excellent approach in elderly patients. Arch Surg 138:1083–1088CrossRefPubMed
3.
Zurück zum Zitat Panis Y (2000) Laparoscopic surgery for benign colorectal diseases. J Chir (Paris) 137:261–267 Panis Y (2000) Laparoscopic surgery for benign colorectal diseases. J Chir (Paris) 137:261–267
4.
Zurück zum Zitat Meza R, Jeon J, Renehan AG, Luebeck EG (2010) Colorectal cancer incidence trends in the United States and United Kingdom: evidence of right- to left-sided biological gradients with implications for screening. Cancer Res 70:5419–5429CrossRefPubMed Meza R, Jeon J, Renehan AG, Luebeck EG (2010) Colorectal cancer incidence trends in the United States and United Kingdom: evidence of right- to left-sided biological gradients with implications for screening. Cancer Res 70:5419–5429CrossRefPubMed
5.
Zurück zum Zitat Reza M, Blasco JA, Andradas E, Cantero R, Mayol J (2006) Systematic review of laparoscopic versus open surgery for colorectal cancer. Br J Surg 93:921–928CrossRefPubMed Reza M, Blasco JA, Andradas E, Cantero R, Mayol J (2006) Systematic review of laparoscopic versus open surgery for colorectal cancer. Br J Surg 93:921–928CrossRefPubMed
6.
Zurück zum Zitat Hong D, Lewis M, Tabet J, Anvari M (2002) Prospective comparison of laparoscopic versus open resection for benign colorectal disease. Surg Laparosc Endosc Percutan Tech 12:238–242CrossRefPubMed Hong D, Lewis M, Tabet J, Anvari M (2002) Prospective comparison of laparoscopic versus open resection for benign colorectal disease. Surg Laparosc Endosc Percutan Tech 12:238–242CrossRefPubMed
7.
Zurück zum Zitat DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7:177–188CrossRefPubMed DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7:177–188CrossRefPubMed
8.
Zurück zum Zitat Vignali A, Di Palo S, Tamburini A, Radaelli G, Orsenigo E, Staudacher C (2005) Laparoscopic vs. open colectomies in octogenarians: a case-matched control study. Dis Colon Rectum 48:2070–2075CrossRefPubMed Vignali A, Di Palo S, Tamburini A, Radaelli G, Orsenigo E, Staudacher C (2005) Laparoscopic vs. open colectomies in octogenarians: a case-matched control study. Dis Colon Rectum 48:2070–2075CrossRefPubMed
9.
Zurück zum Zitat Tei M, Ikeda M, Haraguchi N, Takemasa I, Mizushima T, Ishii H, Yamamoto H, Sekimoto M, Doki Y, Mori M (2009) Postoperative complications in elderly patients with colorectal cancer comparison of open and laparoscopic surgical procedures. Surg Laparosc Endosc Percutan Tech 19:488–492CrossRefPubMed Tei M, Ikeda M, Haraguchi N, Takemasa I, Mizushima T, Ishii H, Yamamoto H, Sekimoto M, Doki Y, Mori M (2009) Postoperative complications in elderly patients with colorectal cancer comparison of open and laparoscopic surgical procedures. Surg Laparosc Endosc Percutan Tech 19:488–492CrossRefPubMed
10.
Zurück zum Zitat Tuech JJ, Pessaux P, Rouge C, Regenet N, Bergamaschi R, Arnaud JP (2000) Laparoscopic vs. open colectomy for sigmoid diverticulitis: a prospective comparative study in the elderly. Surg Endosc 14:1031–1033CrossRefPubMed Tuech JJ, Pessaux P, Rouge C, Regenet N, Bergamaschi R, Arnaud JP (2000) Laparoscopic vs. open colectomy for sigmoid diverticulitis: a prospective comparative study in the elderly. Surg Endosc 14:1031–1033CrossRefPubMed
11.
Zurück zum Zitat Stocchi L, Nelson H, Young-Fadok TM, Larson DR, Ilstrup DM (2000) Safety and advantages of laparoscopic vs. open colectomy in the elderly: matched-control study. Dis Colon Rectum 43:326–332CrossRefPubMed Stocchi L, Nelson H, Young-Fadok TM, Larson DR, Ilstrup DM (2000) Safety and advantages of laparoscopic vs. open colectomy in the elderly: matched-control study. Dis Colon Rectum 43:326–332CrossRefPubMed
12.
Zurück zum Zitat Stewart BT, Stitz RW, Lumley JW (1999) Laparoscopically assisted colorectal surgery in the elderly. Br J Surg 86:938–941CrossRefPubMed Stewart BT, Stitz RW, Lumley JW (1999) Laparoscopically assisted colorectal surgery in the elderly. Br J Surg 86:938–941CrossRefPubMed
13.
Zurück zum Zitat Sklow B, Read T, Birnbaum E, Fry R, Fleshman J (2003) Age and type of procedure influence the choice of patients for laparoscopic colectomy. Surg Endosc 17:923–929CrossRefPubMed Sklow B, Read T, Birnbaum E, Fry R, Fleshman J (2003) Age and type of procedure influence the choice of patients for laparoscopic colectomy. Surg Endosc 17:923–929CrossRefPubMed
14.
Zurück zum Zitat Senagore A, Madbouly K, Fazio V, Duepree H, Brady K, Delaney C (2003) Advantages of laparoscopic colectomy in older patients. Arch Surg 138:252–256CrossRefPubMed Senagore A, Madbouly K, Fazio V, Duepree H, Brady K, Delaney C (2003) Advantages of laparoscopic colectomy in older patients. Arch Surg 138:252–256CrossRefPubMed
15.
Zurück zum Zitat Lin KL, Chang TC, Huang J, Lin BR, Liang JT (2010) Laparoscopic colectomy for nonagenarians, preliminary experience in National Taiwan University Hospital. J Soc Colon Rectal Surgeon (Taiwan) 21:177–186 Lin KL, Chang TC, Huang J, Lin BR, Liang JT (2010) Laparoscopic colectomy for nonagenarians, preliminary experience in National Taiwan University Hospital. J Soc Colon Rectal Surgeon (Taiwan) 21:177–186
16.
Zurück zum Zitat Lian L, Kalady M, Geisler D, Kiran R (2010) Laparoscopic colectomy is safe and leads to a significantly shorter hospital stay for octogenarians. Surg Endosc 24:2039–2043CrossRefPubMed Lian L, Kalady M, Geisler D, Kiran R (2010) Laparoscopic colectomy is safe and leads to a significantly shorter hospital stay for octogenarians. Surg Endosc 24:2039–2043CrossRefPubMed
17.
Zurück zum Zitat Law WL, Chu KW, Tung P (2002) Laparoscopic colorectal resection: a safe option for elderly patients. J Am Coll Surg 195:768–773CrossRefPubMed Law WL, Chu KW, Tung P (2002) Laparoscopic colorectal resection: a safe option for elderly patients. J Am Coll Surg 195:768–773CrossRefPubMed
18.
Zurück zum Zitat Frasson M, Braga M, Vignali A, Zuliani W, Di Carlo V (2008) Benefits of laparoscopic colorectal resection are more pronounced in elderly patients. Dis Colon Rectum 51:296–300CrossRefPubMed Frasson M, Braga M, Vignali A, Zuliani W, Di Carlo V (2008) Benefits of laparoscopic colorectal resection are more pronounced in elderly patients. Dis Colon Rectum 51:296–300CrossRefPubMed
19.
Zurück zum Zitat Kuhry E, Schwenk W, Gaupset R, Romild U, Bonjer HJ (2008) Long-term results of laparoscopic colorectal cancer resection. Cochrane Database Syst Rev (2):CD003432 Kuhry E, Schwenk W, Gaupset R, Romild U, Bonjer HJ (2008) Long-term results of laparoscopic colorectal cancer resection. Cochrane Database Syst Rev (2):CD003432
20.
Zurück zum Zitat Irvin TT (1998) Prognosis of colorectal cancer in the elderly. Br J Surg 75:419–421CrossRef Irvin TT (1998) Prognosis of colorectal cancer in the elderly. Br J Surg 75:419–421CrossRef
21.
Zurück zum Zitat Fujita T, Sakurai K (1995) Multivariate analysis of risk factors for postoperative pneumonia. Am J Surg 169:304–307CrossRefPubMed Fujita T, Sakurai K (1995) Multivariate analysis of risk factors for postoperative pneumonia. Am J Surg 169:304–307CrossRefPubMed
22.
Zurück zum Zitat Brooks-Brunn J (1997) Predictors of postoperative pulmonary complications following abdominal surgery. Chest 111:563–571CrossRef Brooks-Brunn J (1997) Predictors of postoperative pulmonary complications following abdominal surgery. Chest 111:563–571CrossRef
23.
Zurück zum Zitat Garibaldi R, Britt MR, Coleman ML, Reading JC, Pace NL (1981) Risk factors for postoperative pneumonia. Am J Med 70:677–680CrossRefPubMed Garibaldi R, Britt MR, Coleman ML, Reading JC, Pace NL (1981) Risk factors for postoperative pneumonia. Am J Med 70:677–680CrossRefPubMed
24.
Zurück zum Zitat Iwamoto K, Ichiyama S, Shimokata K, Nakashima N (1993) Postoperative pneumonia in elderly patients: incidence and mortality in comparison with younger patients. Intern Med 32:274–277CrossRefPubMed Iwamoto K, Ichiyama S, Shimokata K, Nakashima N (1993) Postoperative pneumonia in elderly patients: incidence and mortality in comparison with younger patients. Intern Med 32:274–277CrossRefPubMed
25.
Zurück zum Zitat Lamont CT, Sampson S, Matthias R, Kane R (1983) The outcome of hospitalization for acute illness in the elderly. J Am Geriatr Soc 31:282–288PubMed Lamont CT, Sampson S, Matthias R, Kane R (1983) The outcome of hospitalization for acute illness in the elderly. J Am Geriatr Soc 31:282–288PubMed
26.
Zurück zum Zitat Gill TM, Allore HG, Gahbauer EA, Murphy TE (2010) Change in disability after hospitalization or restricted activity in older persons. JAMA 304:1919–1928CrossRefPubMed Gill TM, Allore HG, Gahbauer EA, Murphy TE (2010) Change in disability after hospitalization or restricted activity in older persons. JAMA 304:1919–1928CrossRefPubMed
27.
Zurück zum Zitat Monk TG, Weldon BC, Garvan CW, Dede DE, van der Aa MT, Heilman KM, Gravenstein JS (2008) Predictors of cognitive dysfunction after major noncardiac surgery. Anesthesiology 108:18–30CrossRefPubMed Monk TG, Weldon BC, Garvan CW, Dede DE, van der Aa MT, Heilman KM, Gravenstein JS (2008) Predictors of cognitive dysfunction after major noncardiac surgery. Anesthesiology 108:18–30CrossRefPubMed
28.
Zurück zum Zitat Kojima Y, Narita M (2006) Postoperative outcome among elderly patients after general anesthesia. Acta Anaesthesiol Scand 50:19–25CrossRefPubMed Kojima Y, Narita M (2006) Postoperative outcome among elderly patients after general anesthesia. Acta Anaesthesiol Scand 50:19–25CrossRefPubMed
29.
Zurück zum Zitat Kirkbride DA, Parker JL, Williams GD, Buggy DJ (2001) Induction of anesthesia in the elderly ambulatory patient: a double-blinded comparison of propofol and sevoflurane. Anesth Analg 93:1185–1187CrossRefPubMed Kirkbride DA, Parker JL, Williams GD, Buggy DJ (2001) Induction of anesthesia in the elderly ambulatory patient: a double-blinded comparison of propofol and sevoflurane. Anesth Analg 93:1185–1187CrossRefPubMed
Metadaten
Titel
Laparoscopic versus open colorectal resection in the elderly population
verfasst von
Katherine Grailey
Sheraz R. Markar
Alan Karthikesalingam
Rima Aboud
Paul Ziprin
Omar Faiz
Publikationsdatum
01.01.2013
Verlag
Springer-Verlag
Erschienen in
Surgical Endoscopy / Ausgabe 1/2013
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-012-2414-1

Weitere Artikel der Ausgabe 1/2013

Surgical Endoscopy 1/2013 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.