Laparoscopic versus open colorectal resection in the elderly population.

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.

• Authors: Katherine Grailey, Sheraz R Markar, Alan Karthikesalingam, Rima Aboud, Paul Ziprin, Omar Faiz
• Journal: Surgical endoscopy (Surg Endosc) Vol. 27 Issue 1 Pg. 19-30 (Jan 2013) ISSN: 1432-2218 [Electronic] Germany
• PMID: 22752280 (Publication Type: Comparative Study, Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Review, Systematic Review)

Topics

• Aged
• Aged, 80 and over
• Blood Loss, Surgical (statistics & numerical data)
• Colonic Diseases (surgery)
• Humans
• Laparoscopy (methods)
• Length of Stay (statistics & numerical data)
• Operative Time
• Postoperative Complications (etiology)
• Recovery of Function
• Rectal Diseases (surgery)
• Treatment Outcome