Laparoscopic colorectal surgery in the elderly.

BACKGROUND

The efficacy and safety of laparoscopic colorectal surgery have been demonstrated in several well designed trials in recent years. At the same time the experience in the field of laparoscopy in the elderly has increased. The aim of this study was to evaluate retrospectively the experience of laparoscopic colorectal surgery in patients over 75 years in our unit.

DESIGN

Retrospective study.

SETTING

Surgical Department, San Lorenzo Hospital, Valdagno (VI).

SUBJECTS AND

METHODS

All the patients over 75 years, out of a total number of 121 unselected patients, undergoing laparoscopic colectomy or laparoscopic abdomino-perineal resection between June 2002 and May 2005.

MAIN OUTCOME MEASURES: Postoperative mortality, operating time, conversion rate, morbidity, time of discharge from hospital.

RESULTS

Six patients were converted to open surgery. 87 patients over 75 years underwent laparoscopic colorectal surgery. There was no postoperative death, in three cases a reoperation was done, because of postoperative intestinal obstruction in one case (over 75) and for anastomotic fistula in two (one over 75, after low anterior resection). Mean operative time was was 180 minutes (range 150-300).

CONCLUSIONS

Laparoscopic colorectal surgery in elderly patients is a safe group of procedures for benign and malignant lesions of large bowel, resulting in a low rate of complications even if the time of operation is increased compared with open procedures. Postoperative pain and hospital stay, with return to normal life, are decreased compared with open surgery.