Annals of Coloproctology

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Original Article

The First Year After Colorectal Surgery in the Elderly: Verena N.N. Kornmann, Jeroen L.A. van Vugt, Anke B. Smits, Bert van Ramshorst, Djamila Boerma; Ann Coloproctol. 2017;33(4):134-138. Published online August 31, 2017; DOI: https://doi.org/10.3393/ac.2017.33.4.134

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Purpose

Surgery for colorectal malignancy is increasingly being performed in the elderly. Little is known about the impact of complications on late mortality. This study aimed to analyze whether a complicated postoperative course affects the 1-year survival in elderly patients.

Methods

All consecutive patients older than 75 years of age who underwent colorectal cancer surgery between January 2009 and April 2013 were included in this study. The main outcome was mortality at 1 year after surgery. Logistic regression analyses were performed to determine risk factors for a poor outcome (mortality) after survival of the early postoperative course of surgery at 1-year follow-up. Patients who died within 30 days postoperatively were excluded from analysis.

Results

The early mortality rate was 6.3% (n = 15), and 2 patients died during follow-up as a result of complications after a second surgery. A total of 223 patients survived the perioperative period and were included in this study. Twenty-two patients (9.9%) died during the first year of follow-up. Stage IV disease (P = 0.002), complications of primary surgery (P = 0.016), and comorbidity (P = 0.050) were risk factors for 1-year mortality. Intensive care unit stay, reoperation and readmission were not associated with a worse 1-year outcome.

Conclusion

Elderly patients with stage IV disease at the time of surgery, comorbidity, and postoperative complications are at risk for mortality during the first year after surgery. A patient-tailored approach with special attention to perioperative care should be considered in the elderly.

Citations

Citations to this article as recorded by

Medical versus surgical causes of death following colorectal resection: a Queensland Audit of Surgical Mortality (QASM) study
Derek Mao, Therese Rey‐Conde, John B. North, Raymond P. Lancashire, Sanjeev Naidu, Terence Chua
ANZ Journal of Surgery.2024; 94(4): 684. CrossRef
Factors associated with one-year mortality after curative surgery for primary clinical T4 and locally recurrent rectal cancer in elderly patients
Nikki C.M. van Ham, Sofie Glazemakers, Mirjam van der Ende-van Loon, Grard A.P. Nieuwenhuijzen, Harm J.T. Rutten, Jip L. Tolenaar, Anne Jacobs, Jacobus W.A. Burger, Stijn H.J. Ketelaers, Johanne G. Bloemen
European Journal of Surgical Oncology.2024; 50(6): 108259. CrossRef
Outcomes of Robot-Assisted Versus Laparoscopic Surgery for Colorectal Cancer in Adults Aged 75 Years and Older: A Propensity Score–Matched Analysis of the US Nationwide Inpatient Sample
Kuan-Chih Chung, Kuen-Lin Wu, Yu-Li Su, Kung-Chuan Cheng, Chien-En Tang, Ling-Chiao Song, Hong-Hwa Chen, Ko-Chao Lee
Diseases of the Colon & Rectum.2024; 67(9): 1121. CrossRef
Robot-assisted vs. laparoscopic right hemicolectomy in octogenarians and nonagenarians: an analysis of the US nationwide inpatient sample 2005–2018
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Robotic surgery in elderly patients with colorectal cancer: Review of the current literature
Nan Zun Teo, James Chi Yong Ngu
World Journal of Gastrointestinal Surgery.2023; 15(6): 1040. CrossRef
Surgical outcomes following colorectal cancer resections in patients aged 80 years and over: results from the Australia and New Zealand Binational Colorectal Cancer Audit
Andrea J. Cross, Pauline Kornfält, Jacqueline Lidin, Pamela Buchwald, Frank A. Frizelle, Timothy W. Eglinton
Colorectal Disease.2021; 23(4): 814. CrossRef
Routine postoperative intensive care unit admission after colorectal cancer surgery for the elderly patient reduces postoperative morbidity and mortality
M. Fahim, R. A. Visser, L. M. Dijksman, D. H. Biesma, P. G. Noordzij, A. B. Smits
Colorectal Disease.2020; 22(4): 408. CrossRef
When and how should surgery be performed in senior colorectal cancer patients?
S.H.J. Ketelaers, M. Fahim, H.J.T. Rutten, A.B. Smits, R.G. Orsini
European Journal of Surgical Oncology.2020; 46(3): 326. CrossRef
Surgical approach and geriatric evaluation for elderly patients with colorectal cancer
Marco Vacante, Erika Cristaldi, Francesco Basile, Antonio Maria Borzì, Antonio Biondi
Updates in Surgery.2019; 71(3): 411. CrossRef
Significant improvement in postoperative and 1-year mortality after colorectal cancer surgery in recent years
S.H.J. Ketelaers, R.G. Orsini, J.W.A. Burger, G.A.P. Nieuwenhuijzen, H.J.T. Rutten
European Journal of Surgical Oncology.2019; 45(11): 2052. CrossRef
Screening and systematic follow-up for cardiopulmonary comorbidity in elective surgery for colorectal cancer: a randomised feasibility study
Hans B. Rahr, Susanna Streym, Charlotte G. Kryh-Jensen, Helene T. Hougaard, Anne S. Knudsen, Steffen H. Kristensen, Ejler Ejlersen
World Journal of Surgical Oncology.2019;[Epub] CrossRef
Robotic Versus Laparoscopic Colorectal Cancer Surgery in Elderly Patients: A Propensity Score Match Analysis
Nicola de'Angelis, Solafah Abdalla, Giorgio Bianchi, Riccardo Memeo, Cecile Charpy, Niccolo Petrucciani, Iradj Sobhani, Francesco Brunetti
Journal of Laparoendoscopic & Advanced Surgical Techniques.2018; 28(11): 1334. CrossRef
High Serum CA19-9 Concentration Predicts Poor Prognosis in Elderly Patients with Stage IV Colorectal Cancer
Eiji Hidaka, Chiyo Maeda, Kenta Nakahara, Kunihiko Wakamura, Yasuhiro Ishiyama, Shoji Shimada, Junichi Seki, Yojiro Takano, Sonoko Oae, Yuta Enami, Naruhiko Sawada, Fumio Ishida, Shin-ei Kudo
Gastrointestinal Tumors.2018; 5(3-4): 117. CrossRef
Colorectal Cancer Surgery in Elderly Patients
Young Jin Kim
Annals of Coloproctology.2017; 33(4): 121. CrossRef

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