Security Observation Of Laparoscopic Colorectal Cancer Radical Surgery In Elderly Patients Over 80 Years Of Age

Objective:To evaluate the security and feasibility of laparoscopic radical surgery of colorectal cancer in elderly patients over 80 years of age.Methods:We retrospectively analyzied the perioperative clinical data of 70 cases of colorectal cancer patients who are all over 80 years performed selective radical surgery in Qilu Hospital of Shandong University.25 of which were under laparoscopic radical surgery(LAP group), contrast to 45 under conventional open surgery(OP group). We emphasized to analyze and compare the general clinical data (age,gender, ASA staging, nutritional status and preoperative comorbidities), intraoperative clinical data(operation time and blood loss),and postoperative clinical data(admittance to ICU, recovery time of gastrointestinal function, postoperative complications, VAS score after 72 hours, postoperative hospital stay) between two groups above.Results:1. There was no significant difference between two groups in average age of years, gender ratio, preoperative comorbidities and nutritional status.2. There was no statistical difference between two groups in preoperative ASA scoring(P=0.872). The number of patients of LAP group with stage Ⅱ,Ⅲ and IV were 18,5 and 0, while the number of patients of OP group with grade II, III and IV were 31,12and 2.3. All patients in two groups received selective surgery, including the right, left and sigmoid colon resection, and rectal cancer surgery(Dixon、Miles, Hartmann). There was no significant difference in distribution of operations between two groups.4. The operations of two groups were all performed smoothly. There was no transfer to open surgery in LAP group. The median operation time in LAP Group was 176.8±28.9min, while 141.4±29.4min in OP group, which demonstrating the significant difference(p=0.000). There was statistical difference between two groups in median loss of blood during operation(P=0.000), which was 55.5±22.5ml in LAP group, compared to150.6±34.5ml in OP group.5.9 patients received ICU treatment after surgery in LAP group(36%), and 18 in OP group(40%). Which showing no significant difference(P=0.742). The median recovery time of gastrointestinal function of LAP group was 3.4±1.7 d, contrast to 4.3±1.3 d in OP group(P=0.026). Which was statistical different(P=0.018). The median VAS score after 72 hours of operation in LAP group was 2.8±0.5, which was 3.9±0.6 in OP group.The degree of pain of patients in LAP group was lighter than OP group. The median postoperative hospital stay in LAP group was (11.3±3.0)d, which was significantly shorter than that of OP group(14.8±6.8)d (p=0.015).6. There was one patient died in two groups respectively. The incidence rate of postoperative complications of LAP group was 24%(6/25),46.7%(21/45) in the OP group (P=0.027).Conclusions:Compared with conventional open surgery, the laparoscopic surgery performed in colorectal cancer patients over 80 years of age was characterized by less invasion, less pain, faster recovery, lower incidence of complications. And satisfied short-term effect was seen. Therefore, the security and feasibility of laparoscopic surgery in colorectal cancer patients over 80 years of age is worth acknowledging when postoperative administration is reinforced.