Yıl: 2021 Cilt: 41 Sayı: 4 Sayfa Aralığı: 485 - 490 Metin Dili: İngilizce DOI: 10.5336/medsci.2021-84099 İndeks Tarihi: 21-03-2022

Evaluation of the Feasibility and Safety of Laparoscopic Resection in Elderly Colorectal Cancer Patients: A Retrospective Study

Öz:
Objective: The incidence of colorectal cancer gradually increases with age. The fact that elderly patients have frequent comorbidities and limited functional reserve requires surgeons to choose the most optimal surgical method. The aim of this study is to investigate the safety and applicability of laparoscopic surgery in elderly colorectal cancer patients ≥70 years old. Material and Methods: The data of 153 patients, who underwent laparoscopic resection for colorectal cancer in our clinic in the period between January 2014 and January 2019, were retrospectively investigated. We divided patients into 2 groups by age; elderly patients (≥70 years old, 55 cases) and non-elderly patients (<70 years old, 98 cases). Patient characteristics, clinicopathological findings, surgical findings, short-term and long-term outcomes were compared between the age groups. Results: The rate of patients with high American Society of Anesthesiologists score (p<0.001) and the rate of comorbid diseases (87.3%) were found to be higher in the elderly group (p<0.001). There was no difference between the groups in terms of postoperative complications other than atelectasis (p=0.037). In-hospital mortality rates (p=0.423), re-operation rates (p=0.999), intensive care unit (p=0.741) and hospital stay (p=0.997) of the groups were similar. When the longterm results are examined, no statistically significant differences were found between the age groups in terms of overall survival (p=0.150) and disease-free survival (p=0.449). Conclusion: Laparoscopic surgery is a safe and applicable surgical method for elderly colorectal cancer patients in terms of both short and long term oncologic results.
Anahtar Kelime:

Yaşlı Kolorektal Kanserli Hastalarda Laparoskopik Rezeksiyonun Uygulanabilirliği ve Güvenliğinin Değerlendirilmesi: Retrospektif Çalışma

Öz:
Amaç: Kolorektal kanser insidansı yaşla birlikte giderek artmaktadır. Yaşlı hastaların komorbiditelerinin sık olması ve fonksiyonel rezervin sınırlı olması, cerrahların en uygun cerrahi yöntemi seçmesini gerektirmektedir. Bu çalışmanın amacı, ≥70 yaşındaki kolorektal kanser hastalarında laparoskopik cerrahinin güvenliğini ve uygulanabilirliğini araştırmaktır. Gereç ve Yöntemler: Ocak 2014-Ocak 2019 tarihleri arasında kliniğimizde kolorektal kanser nedeniyle laparoskopik rezeksiyon yapılan 153 hastanın verileri, retrospektif olarak incelendi. Hastaları yaşa göre 2 gruba ayırdık; yaşlı hastalar (≥70 yaş, 55 vaka) ve yaşlı olmayan hastalar (<70 yaş, 98 vaka). Hasta özellikleri, klinikopatolojik bulgular, cerrahi bulgular, kısa ve uzun dönem sonuçlar yaş grupları arasında karşılaştırıldı. Bulgular: Amerikan Anestezistler Derneği skoru yüksek olan hasta oranı (p<0,001) ve komorbid hastalık oranı (%87,3) yaşlı grupta daha yüksek bulundu (p<0,001). Atelektazi dışında postoperatif komplikasyonlar açısından gruplar arasında fark yoktu (p=0,037). Grupların hastane içi mortalite oranları (p=0,423), re-operasyon oranları (p=0,999), yoğun bakım ünitesi (p=0,741) ve hastanede kalış (p=0,997) süreleri benzerdi. Uzun dönem sonuçlar incelendiğinde genel sağkalım (p=0,150) ve hastalıksız sağkalım (p=0,449) açısından yaş grupları arasında istatistiksel olarak anlamlı fark bulunmadı. Sonuç: Laparoskopik cerrahi, hem kısa hem de uzun dönem onkolojik sonuçlar açısından yaşlı kolorektal kanserli hastalar için güvenli ve uygulanabilir bir cerrahi yöntemdir.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Inoue Y, Kawamoto A, Okugawa Y, Hiro J, Saigusa S, Toiyama Y, et al. Efficacy and safety of laparoscopic surgery in elderly patients with colorectal cancer. Mol Clin Oncol. 2015;3(4): 897-901. [Crossref] [PubMed] [PMC]
  • 2. Sanoff HK, Bleiberg H, Goldberg RM. Managing older patients with colorectal cancer. J Clin Oncol. 2007;25(14):1891-7. [Crossref] [PubMed]
  • 3. Latkauskas T, Rudinskaite G, Kurtinaitis J, Janciauskiene R, Tamelis A, Saladzinskas Z, et al. The impact of age on post-operative outcomes of colorectal cancer patients undergoing surgical treatment. BMC Cancer. 2005;5:153. [Crossref] [PubMed] [PMC]
  • 4. Turrentine FE, Wang H, Simpson VB, Jones RS. Surgical risk factors, morbidity, and mortality in elderly patients. J Am Coll Surg. 2006;203(6):865-77. [Crossref] [PubMed]
  • 5. Payne JE, Chapuis PH, Pheils MT. Surgery for large bowel cancer in people aged 75 years and older. Dis Colon Rectum. 1986;29(11): 733-7. [Crossref] [PubMed]
  • 6. Alves A, Panis Y, Mathieu P, Mantion G, Kwiatkowski F, Slim K; Association Française de Chirurgie. Postoperative mortality and morbidity in French patients undergoing colorectal surgery: results of a prospective multicenter study. Arch Surg. 2005;140(3):278-83, discussion 284. [Crossref] [PubMed]
  • 7. Weber DM. Laparoscopic surgery: an excellent approach in elderly patients. Arch Surg. 2003;138(10):1083-8. [Crossref] [PubMed]
  • 8. Stocchi L, Nelson H, Young-Fadok TM, Larson DR, Ilstrup DM. Safety and advantages of laparoscopic vs. open colectomy in the elderly: matched-control study. Dis Colon Rectum. 2000;43(3):326-32. [Crossref] [PubMed]
  • 9. Law WL, Chu KW, Tung PH. Laparoscopic colorectal resection: a safe option for elderly patients. J Am Coll Surg. 2002;195(6):768-73. [Crossref] [PubMed]
  • 10. Chautard J, Alves A, Zalinski S, Bretagnol F, Valleur P, Panis Y. Laparoscopic colorectal surgery in elderly patients: a matched casecontrol study in 178 patients. J Am Coll Surg. 2008;206(2):255-60. [Crossref] [PubMed]
  • 11. Ngu JC, Kuo LJ, Teo NZ. Minimally invasive surgery in the geriatric patient with colon cancer. J Gastrointest Oncol. 2020;11(3):540-4. [Crossref] [PubMed] [PMC]
  • 12. Fiscon V, Portale G, Migliorini G, Frigo F. Laparoscopic resection of colorectal cancer in elderly patients. Tumori. 2010;96(5):704-8. [Crossref] [PubMed]
  • 13. Tan KY, Konishi F, Kawamura YJ, Maeda T, Sasaki J, Tsujinaka S, et al. Laparoscopic colorectal surgery in elderly patients: a case-control study of 15 years of experience. Am J Surg. 2011;201(4):531-6. [Crossref] [PubMed]
  • 14. Ueda Y, Shiraishi N, Kawasaki T, Akagi T, Ninomiya S, Shiroshita H, et al. Short- and longterm outcomes of laparoscopic surgery for colorectal cancer in the elderly aged over 80 years old versus non-elderly: a retrospective cohort study. BMC Geriatr. 2020;20(1):445. [Crossref] [PubMed] [PMC]
  • 15. Kvasnovsky CL, Adams K, Sideris M, Laycock J, Haji AK, Haq A, et al. Elderly patients have more infectious complications following laparoscopic colorectal cancer surgery. Colorectal Dis. 2016;18(1):94-100. [Crossref] [PubMed]
  • 16. Tokuhara K, Nakatani K, Ueyama Y, Yoshioka K, Kon M. Short- and long-term outcomes of laparoscopic surgery for colorectal cancer in the elderly: A prospective cohort study. Int J Surg. 2016;27:66-71. [Crossref] [PubMed]
  • 17. Jafari MD, Jafari F, Halabi WJ, Nguyen VQ, Pigazzi A, Carmichael JC, et al. Colorectal Cancer Resections in the Aging US Population: A Trend Toward Decreasing Rates and Improved Outcomes. JAMA Surg. 2014; 149(6):557-64. [Crossref] [PubMed]
  • 18. Bossard N, Velten M, Remontet L, Belot A, Maarouf N, Bouvier AM, et al. Survival of cancer patients in France: a population-based study from The Association of the French Cancer Registries (FRANCIM). Eur J Cancer. 2007;43(1):149-60. [Crossref] [PubMed]
  • 19. Ngu JC, Kuo LJ, Teo NZ. Minimally invasive surgery in the geriatric patient with colon cancer. J Gastrointest Oncol. 2020;11(3):540-4. [Crossref] [PubMed] [PMC]
  • 20. Fiscon V, Portale G, Frigo F, Migliorini G. Laparoscopic resection of colorectal cancer: matched comparison in elderly and younger patients. Tech Coloproctol. 2010;14(4):323-7. [Crossref] [PubMed]
  • 21. Jeong DH, Hur H, Min BS, Baik SH, Kim NK. Safety and feasibility of a laparoscopic colorectal cancer resection in elderly patients. Ann Coloproctol. 2013;29(1):22-7. [Crossref] [PubMed] [PMC]
APA Gojayev A, Ünal A (2021). Evaluation of the Feasibility and Safety of Laparoscopic Resection in Elderly Colorectal Cancer Patients: A Retrospective Study. , 485 - 490. 10.5336/medsci.2021-84099
Chicago Gojayev Afig,Ünal Ali Ekrem Evaluation of the Feasibility and Safety of Laparoscopic Resection in Elderly Colorectal Cancer Patients: A Retrospective Study. (2021): 485 - 490. 10.5336/medsci.2021-84099
MLA Gojayev Afig,Ünal Ali Ekrem Evaluation of the Feasibility and Safety of Laparoscopic Resection in Elderly Colorectal Cancer Patients: A Retrospective Study. , 2021, ss.485 - 490. 10.5336/medsci.2021-84099
AMA Gojayev A,Ünal A Evaluation of the Feasibility and Safety of Laparoscopic Resection in Elderly Colorectal Cancer Patients: A Retrospective Study. . 2021; 485 - 490. 10.5336/medsci.2021-84099
Vancouver Gojayev A,Ünal A Evaluation of the Feasibility and Safety of Laparoscopic Resection in Elderly Colorectal Cancer Patients: A Retrospective Study. . 2021; 485 - 490. 10.5336/medsci.2021-84099
IEEE Gojayev A,Ünal A "Evaluation of the Feasibility and Safety of Laparoscopic Resection in Elderly Colorectal Cancer Patients: A Retrospective Study." , ss.485 - 490, 2021. 10.5336/medsci.2021-84099
ISNAD Gojayev, Afig - Ünal, Ali Ekrem. "Evaluation of the Feasibility and Safety of Laparoscopic Resection in Elderly Colorectal Cancer Patients: A Retrospective Study". (2021), 485-490. https://doi.org/10.5336/medsci.2021-84099
APA Gojayev A, Ünal A (2021). Evaluation of the Feasibility and Safety of Laparoscopic Resection in Elderly Colorectal Cancer Patients: A Retrospective Study. Türkiye Klinikleri Tıp Bilimleri Dergisi, 41(4), 485 - 490. 10.5336/medsci.2021-84099
Chicago Gojayev Afig,Ünal Ali Ekrem Evaluation of the Feasibility and Safety of Laparoscopic Resection in Elderly Colorectal Cancer Patients: A Retrospective Study. Türkiye Klinikleri Tıp Bilimleri Dergisi 41, no.4 (2021): 485 - 490. 10.5336/medsci.2021-84099
MLA Gojayev Afig,Ünal Ali Ekrem Evaluation of the Feasibility and Safety of Laparoscopic Resection in Elderly Colorectal Cancer Patients: A Retrospective Study. Türkiye Klinikleri Tıp Bilimleri Dergisi, vol.41, no.4, 2021, ss.485 - 490. 10.5336/medsci.2021-84099
AMA Gojayev A,Ünal A Evaluation of the Feasibility and Safety of Laparoscopic Resection in Elderly Colorectal Cancer Patients: A Retrospective Study. Türkiye Klinikleri Tıp Bilimleri Dergisi. 2021; 41(4): 485 - 490. 10.5336/medsci.2021-84099
Vancouver Gojayev A,Ünal A Evaluation of the Feasibility and Safety of Laparoscopic Resection in Elderly Colorectal Cancer Patients: A Retrospective Study. Türkiye Klinikleri Tıp Bilimleri Dergisi. 2021; 41(4): 485 - 490. 10.5336/medsci.2021-84099
IEEE Gojayev A,Ünal A "Evaluation of the Feasibility and Safety of Laparoscopic Resection in Elderly Colorectal Cancer Patients: A Retrospective Study." Türkiye Klinikleri Tıp Bilimleri Dergisi, 41, ss.485 - 490, 2021. 10.5336/medsci.2021-84099
ISNAD Gojayev, Afig - Ünal, Ali Ekrem. "Evaluation of the Feasibility and Safety of Laparoscopic Resection in Elderly Colorectal Cancer Patients: A Retrospective Study". Türkiye Klinikleri Tıp Bilimleri Dergisi 41/4 (2021), 485-490. https://doi.org/10.5336/medsci.2021-84099