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Erschienen in: International Journal of Colorectal Disease 8/2019

28.06.2019 | Short Communication

The influence of pulmonary comorbidities on treatment choice and short-term surgical outcomes among elderly patients with colorectal cancer

verfasst von: Takeshi Nishikawa, Kazushige Kawai, Shigenobu Emoto, Koji Murono, Masaya Hiyoshi, Manabu Kaneko, Hirofumi Sonoda, Kazuhito Sasaki, Yasutaka Shuno, Toshiaki Tanaka, Keisuke Hata, Hiroaki Nozawa

Erschienen in: International Journal of Colorectal Disease | Ausgabe 8/2019

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Abstract

Purpose

Most elderly patients with colorectal cancer have comorbidities and reduced functional reserve, which may increase their risks of postoperative morbidity and mortality, and subsequently influence the treatment choice. Therefore, this study aimed to investigate the treatment choice and compare laparoscopic and open surgery in this setting.

Methods

This retrospective study evaluated 118 patients with colorectal cancer (≥ 85 years old between January 2007 and February 2018) to determine the influence of comorbidities on treatment choice, as well as the safety and feasibility of laparoscopic surgery for these patients.

Results

The patients included 42 men (35.6%) and 106 patients (89.8%) with comorbidities. The treatments were curative resection for 90 patients and palliative surgery for 16 patients, including 5 cases of colostomy/ileostomy because of the difficulty of primary cancer resection, pneumonia, or pulmonary hypertension. Twelve patients received non-surgical treatment, including 7 patients with decreased respiratory function because of chronic obstructive pulmonary disease or pneumonia. Forty-three patients underwent open curative resection and 47 patients underwent laparoscopic curative resection, which was associated with a significantly shorter hospital stay (14 days vs. 19days, P < 0.01), a lower morbidity rate (17.0% vs. 37.2%, P = 0.035), and less blood loss (10 mL vs. 140 mL, P < 0.01). One patient in each group died during the postoperative period because of worsened pre-existing pneumonia.

Conclusion

Laparoscopic surgery was safer and less invasive than open surgery for colorectal cancer among ≥ 85-year-old patients. Pulmonary comorbidities affected the choice of non-curative surgery and may be related to the risk of postoperative mortality.
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Metadaten
Titel
The influence of pulmonary comorbidities on treatment choice and short-term surgical outcomes among elderly patients with colorectal cancer
verfasst von
Takeshi Nishikawa
Kazushige Kawai
Shigenobu Emoto
Koji Murono
Masaya Hiyoshi
Manabu Kaneko
Hirofumi Sonoda
Kazuhito Sasaki
Yasutaka Shuno
Toshiaki Tanaka
Keisuke Hata
Hiroaki Nozawa
Publikationsdatum
28.06.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
International Journal of Colorectal Disease / Ausgabe 8/2019
Print ISSN: 0179-1958
Elektronische ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-019-03336-9

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