Indications for laparoscopic surgery for older rectal cancer patients with comorbidities

• Published in: Surgery today (Tokyo, Japan) Japan), 2021-05, Vol.51 (5), p.721-726
• Main Authors: Hisamatsu, Yuichi, Kuriyama, Naotaka, Fujimoto, Yoshiaki, Jogo, Tomoko, Hu, Qingjiang, Hokonohara, Kentaro, Nakanishi, Ryota, Ando, Koji, Kimura, Yasue, Oki, Eiji, Mori, Masaki
• Format: Article
• Language: English
• Subjects: Medicine; Medicine & Public Health; Original Article; Surgery; Surgical Oncology
• ISSN: 0941-1291; 1436-2813
• DOI: 10.1007/s00595-020-02140-1

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.