scholarly journals Effect of Age on Laparoscopic Surgery and Postoperative Chemotherapy in Elderly Patients With Colorectal Cancer

2020 ◽  
Vol 36 (4) ◽  
pp. 229-242 ◽  
Author(s):  
Hyun Hee Kim ◽  
Myong Hoon Ihn ◽  
Yun Hee Lee ◽  
Jihyoun Lee ◽  
Sangchul Yun ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Laparoscopic Surgery ◽  
Postoperative Complications ◽  
Adverse Events ◽  
Elderly Patients ◽  
Chemotherapy Regimen ◽  
Postoperative Chemotherapy ◽  
Smoking History ◽  
Curative Intent ◽  
Physical Status Classification

Purpose: We aimed to evaluate the postoperative complications of laparoscopic colorectal cancer (CRC) surgery and the adverse events of postoperative chemotherapy in elderly patients compared to younger patients and to identify the factors influencing the termination of postoperative chemotherapy.Methods: Between June 2015 and May 2018, 188 patients with CRC underwent laparoscopic surgery with curative intent. Patients aged ≥ 70 were defined as elderly. Postoperative complications and adverse events of chemotherapy were assessed by using the Clavien-Dindo classification and the Common Terminology Criteria for Adverse Events, respectively. The clinicopathological factors were analyzed retrospectively.Results: Seventy-eight patients were considered elderly with a mean age of 77.5 ± 5.5 years. Overall postoperative complications occurred in 68 patients (36.2%). Age and primary tumor location were independent predictors of overall postoperative complications. Smoking history was the only independent predictor of major postoperative complications. Of 113 patients who were recommended postoperative chemotherapy, 90 patients (79.6%) received postoperative chemotherapy. Overall adverse events occurred in 40 patients (44.4%). The American Society of Anesthesiologists physical status classification and chemotherapy regimen were significantly associated with overall adverse events. The chemotherapy regimen was the only factor significantly associated with severe adverse events. Of 90 patients, postoperative chemotherapy could not be completed in 11 (12.2%). Age was the only factor significantly associated with stopping postoperative chemotherapy (P = 0.003).Conclusion: This study shows that laparoscopic CRC surgery and postoperative chemotherapy were feasible in elderly patients. Further efforts are needed to ensure that elderly patients have the opportunity to make informed decisions regarding postoperative chemotherapy.

scholarly journals Risk Factors for Postoperative Complications in Elderly After Colorectal Cancer Resection

2017 ◽  
Vol 102 (7-8) ◽  
pp. 299-306 ◽  
Author(s):  
Daisuke Kyuno ◽  
Kazuaki Sasaki ◽  
Keisuke Ohno ◽  
Ai Konno ◽  
Takeshi Murakami ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Logistic Regression ◽  
Laparoscopic Surgery ◽  
Postoperative Complications ◽  
Elderly Patients ◽  
Postoperative Delirium ◽  
Morbidity And Mortality ◽  
Cancer Resection ◽  
Colorectal Cancer Resection

This study aimed to assess perioperative morbidity and mortality in elderly patients following colorectal cancer resection and to investigate risk factors for postoperative complications. This study reviewed 697 consecutive patients who underwent elective colorectal cancer resection between 2005 and 2013 at our institution. Patients were divided into 3 groups according to their age: ≤74 (n = 420), 75 to 89 (n = 261), and ≥90 years (n = 16). Clinical findings, morbidity, and mortality were compared among these groups. Univariate and multivariate logistic regression analyses were performed with clinically relevant variables for the complications that increased with aging. Postoperative delirium and pneumonia showed significant increases with aging. There were no significant differences in mortality and morbidity among the 3 groups, except for the 2 aforementioned diseases. Multiple logistic regression analysis showed that dementia and laparoscopic surgery were independent determinants of postoperative delirium and that age and American Society of Anesthesiologists (ASA) score were independent risk factors for postoperative pneumonia. Dementia, high ASA score, and age were the risk factors for higher postoperative morbidity in elderly patients. Our results demonstrated the effectiveness of laparoscopic surgery for the prevention of postoperative delirium after colorectal resection.

scholarly journals Actual survival after resection of primary colorectal cancer: results from a prospective multicenter study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Inge van den Berg ◽  
Robert R. J. Coebergh van den Braak ◽  
Jeroen L. A. van Vugt ◽  
Jan N. M. Ijzermans ◽  
Stefan Buettner
Keyword(s):  
Colorectal Cancer ◽  
Postoperative Complications ◽  
Multicenter Study ◽  
Survival Data ◽  
Standard Therapy ◽  
Tumor Grade ◽  
National Registry ◽  
Stage I ◽  
Stage Iii ◽  
Curative Intent

Abstract Background Colorectal cancer is the third most common type of cancer in the world. We characterize a cohort of patients who survived up to 5 years without recurrence and identify factors predicting the probability of cure. Methods We analyzed data of patients who underwent curative intent surgery for stage I–III CRC between 2007 and 2012 and who had had been included in a large multicenter study in the Netherlands. Cure was defined as 5-year survival without recurrence. Survival data were retrieved from a national registry. Results Analysis of data of 754 patients revealed a cure rate of 65% (n = 490). Patients with stage I disease and T1- and N0-tumor had the highest probability of cure (94%, 95% and 90%, respectively). Those with a T4-tumor or N2-tumor had the lowest probability of cure (62% and 50%, respectively). A peak in the mortality rate for older patients early in follow-up suggests early excess mortality as an explanation. A similar trend was observed for stage III disease, poor tumor grade, postoperative complications, sarcopenia, and R1 resections. Patients with stage III disease, poor tumor grade, postoperative complications, sarcopenia, and R1 resections show a similar trend for decrease in CSS deaths over time. Conclusion In the studied cohort, the probability of cure for patients with stage I–III CRC ranged from 50 to 95%. Even though most patients will be cured from CRC with standard therapy, standard therapy is insufficient for those with poor prognostic factors, such as high T- and N-stage and poor differentiation grade.

Impact of intraoperative hypocapnia on postoperative complications in laparoscopic surgery for colorectal cancer

Surgery Today ◽  
2021 ◽  
Author(s):  
Satoru Morita ◽  
Masashi Tsuruta ◽  
Koji Okabayashi ◽  
Takashi Ishida ◽  
Kohei Shigeta ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Laparoscopic Surgery ◽  
Postoperative Complications

Laparoscopic Surgery for Colorectal Cancer in Super-Elderly Patients

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Hiroki Hashida ◽  
Ryosuke Mizuno ◽  
Kentaro Iwaki ◽  
Hiroyuki Kanbe ◽  
Tokihiko Sumi ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Laparoscopic Surgery ◽  
Elderly Patients

scholarly journals Laparoscopic surgery for colorectal cancer with persistent descending mesocolon

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Yukiharu Hiyoshi ◽  
Yuji Miyamoto ◽  
Kojiro Eto ◽  
Yohei Nagai ◽  
Masaaki Iwatsuki ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Blood Flow ◽  
Lymph Node ◽  
Laparoscopic Surgery ◽  
Postoperative Complications ◽  
Sigmoid Colon ◽  
Lymph Node Dissection ◽  
Node Dissection ◽  
Marginal Artery ◽  
Ir Imaging

Abstract Background Persistent descending mesocolon (PDM) is caused by the absence of fusion of the descending colon to the retroperitoneum. We herein report two colorectal cancer cases with PDM that were treated with laparoscopic surgery. Case presentation Case 1: a 50-year-old man with sigmoid colon cancer and synchronous liver metastasis. After neoadjuvant chemotherapy, he underwent laparoscopic sigmoidectomy with lymph node dissection cutting the root of the inferior mesenteric artery (IMA) and synchronous liver resection. He experienced postoperative stenosis of the reconstructed colon possibly due to an impaired arterial blood flow in the reconstructed colon. Case 2: a 77-year-old man with rectal cancer. Laparoscopic low anterior resection preserving the left colic artery (LCA) was performed. Intraoperative infrared ray (IR) imaging using indocyanine green (ICG) showed good blood flow of the reconstructed colon. He had no postoperative complications. In cases of PDM, the mesentery of the descending and sigmoid colon containing the LCA is often shortened, and the marginal artery of the reconstructed colon is located close to the root of the LCA. Lymph node dissection accompanied by cutting the LCA carries a risk of marginal artery injury. Therefore, we recommend lymph node dissection preserving the LCA in colorectal cancer patients with PDM in order to maintain the blood flow of the reconstructed colon. If the IMA and LCA absolutely need to be cut for complete lymph node dissection, the marginal artery should be clearly identified and preserved. In addition, intraoperative IR imaging is extremely useful for evaluating colonic perfusion and reducing the risk of anastomotic complications. Conclusion In colorectal cancer surgery in patients with PDM, surgeons should be aware of these tips for maintaining the blood flow of the reconstructed colon and thereby avoid postoperative complications caused by an impaired blood flow.

scholarly journals Identification of the Risk Factors for Postoperative Complications in Elderly Patients with Colorectal Cancer

2016 ◽  
Vol 69 (4) ◽  
pp. 191-196
Author(s):  
Sho Sawazaki ◽  
Yasushi Rino ◽  
Hirohide Inoue ◽  
Norio Yukawa ◽  
Munetaka Masuda
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Postoperative Complications ◽  
Elderly Patients

Fast track multidiscipline treatment versus conventional treatment for colorectal cancer: The results of a prospective randomized controlled study (FTMDT trial).

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 743-743
Author(s):  
Ke-Feng Ding ◽  
Jun Li ◽  
Jiao-Jiao Zhou ◽  
Xiang-Xing Kong ◽  
Jin-Jie He ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Laparoscopic Surgery ◽  
Adverse Events ◽  
Open Surgery ◽  
Conventional Treatment ◽  
Fast Track ◽  
Total Hospital ◽  
Perioperative Treatment ◽  
Randomized Controlled ◽  
Hospital Stays

743 Background: Fast Track Multi-Discipline Treatment (FTMDT) integrates fast-track perioperative treatment (laparoscopic or open surgery) plus XELOX adjuvant chemotherapy for colorectal cancer (CRC). This study aimed to verify the effects of FTMDT model and to clarify the value of laparoscopic surgery in fast-track perioperative treatment. Methods: The study (NCT01080547) was a prospective randomized controlled multi-centers study. Group I (FTMDT) received fast-track treatment plus XELOX chemotherapy (Group Ia received laparoscopic surgery and Group Ib received open surgery). Group II (conventional treatment, CT) received conventional treatment plus mFOLFOX6 chemotherapy (Group IIa received laparoscopic surgery and Group IIb received open surgery). The primary endpoint was total hospital stays during treatment. The secondary endpoints included surgical complications, chemotherapy related adverse events, quality of life and hospitalization costs. Results: Between April 2010 and June 2014, 374 patients were enrolled and 342 patients were finally analyzed. The total hospital stays were shorter in FTMDT than CT (median 13 days vs. 23.5 days, P= 0.0001) but similar between Group Ia and Group Ib (median 13 days vs. 14 days, P= 0.1951). The postoperative hospital stays were shorter in FTMDT than CT (median 6 days vs. 9 days, P= 0.0001) but similar between Group Ia and Group Ib (median 6 days vs. 6 days, P= 0.2160). Resume of flatus and defecation was earlier in FTMDT ( P< 0.05) and Group Ia was the earliest. The in-hospital complication rate was lower in FTMDT (6.40% vs. 14.71%, P= 0.014) but similar between Group Ia and Group Ib. The surgery cost of Group Ib was the lowest ( P< 0.05). The rate of chemotherapy related adverse events was similar between FTMDT and CT( P> 0.05). The EORTC QLQ-C30 physical functioning and fatigue in one week postoperative were better in FTMDT than CT( P< 0.05). Conclusions: FTMDT model enhanced the postoperative recovery of CRC patients. On the premise of fast-track perioperative treatment, laparoscopic surgery showed minor advantage over open surgery which had economic advantages. Clinical trial information: NCT01080547.

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