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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
  • 6,202 View
  • 60 Download
  • 14 Web of Science
  • 14 Citations
AbstractAbstract PDF
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
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    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
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    Diseases of the Colon & Rectum.2024; 67(9): 1121.     CrossRef
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    Aging Clinical and Experimental Research.2024;[Epub]     CrossRef
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    Colorectal Disease.2021; 23(4): 814.     CrossRef
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    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
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Review
Pelvic Floor Rehabilitation to Improve Functional Outcome After a Low Anterior Resection: A Systematic Review
Wilhelmina S Visser, Wouter W te Riele, Djamila Boerma, Bert van Ramshorst, Henderik L van Westreenen
Ann Coloproctol. 2014;30(3):109-114.   Published online June 23, 2014
DOI: https://doi.org/10.3393/ac.2014.30.3.109
  • 12,766 View
  • 239 Download
  • 91 Web of Science
  • 104 Citations
AbstractAbstract PDF
Purpose

Impaired functional outcome is common after a low anterior resection (LAR). Pelvic floor rehabilitation (PFR) might improve functional outcome after a LAR. The aim of this systematic review is to evaluate the effectiveness of PFR in improving functional outcome.

Methods

PubMed, Embase, and the Cochrane Library were searched using the terms fecal incontinence, colorectal neoplasm/surgery, LAR, rectal cancer, anterior resection syndrome, bowel habit, pelvic floor, training, therapy, physical therapy, rehabilitation and biofeedback. Of the 125 identified records, 5 articles were included.

Results

The 5 included studies reported on 321 patients, of which 286 patients (89%) underwent pelvic floor training. Three studies included patients with anterior resection syndrome after a LAR while the remaining studies included a series of patients after a LAR. Functional outcome was mostly assessed by using the Wexner incontinence scale. Quality of life was assessed in one study, and in three studies, rectal manometry was performed. After PFR, the functional outcome was improved in four studies, as was the quality of life.

Conclusion

This systematic review demonstrated that PFR is useful for improving the functional outcome after a LAR. The data are extracted from studies of limited quality, but the available evidence points to the effectiveness of the procedure.

Citations

Citations to this article as recorded by  
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    Diseases of the Colon & Rectum.2019; 62(12): 1423.     CrossRef
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    British Journal of Nursing.2018; 27(5): 237.     CrossRef
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  • Role of transanal irrigation in the treatment of anterior resection syndrome
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  • Le syndrome de résection antérieure du rectum. Quels messages délivrer aux praticiens et aux patients en 2018 ?
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  • Comparison of Pelvic Autonomic Nerve Function Recovery between the Group only with Surgery and Group with Additional Acupuncture and Electrotherapy for Treatment in Patients with Rectal Cancer after Anus-Preserving Operation
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  • Successful Restoration of Fecal Continence Using Sacral Nerve Stimulation Following Chemoradiation and Transanal Excision of an Anal Melanoma With Partial Internal Anal Sphincter Resection: A Case Report
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