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Indications for laparoscopic surgery for older rectal cancer patients with comorbidities

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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.

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Acknowledgements

We thank H. Nikki March, PhD, from Edanz Group (https://en-author-services.edanzgroup.com/ac) for editing a draft of this manuscript.

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Correspondence to Yuichi Hisamatsu.

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Hisamatsu, Y., Kuriyama, N., Fujimoto, Y. et al. Indications for laparoscopic surgery for older rectal cancer patients with comorbidities. Surg Today 51, 721–726 (2021). https://doi.org/10.1007/s00595-020-02140-1

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  • DOI: https://doi.org/10.1007/s00595-020-02140-1

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