Risk Factors for Severe Postoperative Complications After Laparoscopic Colorectal Cancer Surgery in Octogenarians: A Retrospective Cohort Study.

PURPOSE: To evaluate the incidence and risk factors of severe postoperative complications in patients aged ≥80 years undergoing laparoscopic colorectal cancer surgery.

PATIENTS AND

METHODS

Patients aged ≥80 years who underwent laparoscopic colorectal cancer surgery between February 2007 and September 2018. Severe complications were defined as Clavien-Dindo grade III or higher. Univariate and multivariate logistic regression analyses were performed to identify risk factors.

RESULTS

Among 170 patients, 26 (15.3%) experienced severe postoperative complications. Gastrointestinal events were most common (8.0%), followed by respiratory (3.5%) and cardiovascular (2.9%) complications. Two patients (1.2%) died postoperatively. Multivariate analysis identified estimated blood loss >100 mL (OR = 4.53, 95% CI: 1.75-11.70, P < 0.01) and age ≥85 years (OR = 4.48, 95% CI: 1.27-15.79, P = 0.02) as independent risk factors. Hemoglobin <120 g/L (OR = 2.56, 95% CI: 0.99-6.60, P = 0.05) and ASA III (OR = 2.49, 95% CI: 0.98-6.35, P = 0.06) showed borderline significance.

CONCLUSION

Severe complications occurred in 15.3% of octogenarians undergoing laparoscopic colorectal cancer surgery. Age ≥85 years and intraoperative blood loss >100 mL were independent risk factors. Preoperative anemia and ASA III were borderline predictors. These factors may aid in perioperative risk stratification and surgical decision-making in elderly patients.