Turkiye Klinikleri Journal of Medical Sciences

.: ORIGINAL RESEARCH
Evaluation of the Feasibility and Safety of Laparoscopic Resection in Elderly Colorectal Cancer Patients: A Retrospective Study
Yaşlı Kolorektal Kanserli Hastalarda Laparoskopik Rezeksiyonun Uygulanabilirliği ve Güvenliğinin Değerlendirilmesi: Retrospektif Çalışma
Afig GOJAYEVa, Ali Ekrem ÜNALa
aDepartment of General Surgery, Division of Surgical Oncology, Ankara University Faculty of Medicine, Ankara, TURKEY
Turkiye Klinikleri J Med Sci. 2021;41(4):485-90
doi: 10.5336/medsci.2021-84099
Article Language: EN
Full Text
ABSTRACT
 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.

Keywords: Aged; colorectal neoplasms; laparoscopy; surgery
ÖZET
 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 Kelimeler: Yaşlı; kolorektal neoplazmlar; laparoskopi; cerrahi
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