Annals of Coloproctology

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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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14 Citations

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
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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
Chien-Chang Lu, Chi-Tung Lu, Kai-Yen Chang, Wang Chun-Li, Chien-Ying Wu
Aging Clinical and Experimental Research.2024;[Epub] CrossRef
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?
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European Journal of Surgical Oncology.2020; 46(3): 326. CrossRef
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Significant improvement in postoperative and 1-year mortality after colorectal cancer surgery in recent years
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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
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Colorectal Cancer Surgery in Elderly Patients
Young Jin Kim
Annals of Coloproctology.2017; 33(4): 121. CrossRef

Quality of Life After a Low Anterior Resection for Rectal Cancer in Elderly Patients: Verena N.N. Kornmann, Marieke S. Walma, Marnix A.J. de Roos, Djamila Boerma, Henderik L. van Westreenen; Ann Coloproctol. 2016;32(1):27-32. Published online February 29, 2016; DOI: https://doi.org/10.3393/ac.2016.32.1.27

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63 Download
12 Web of Science
12 Citations

Abstract PDF

Purpose

Fecal incontinence is a major concern, and its incidence increases with age. Quality of life may decrease due to fecal incontinence after both sphincter-saving surgery and a rectal resection with a permanent stoma. This study investigated quality of life, with regard to fecal incontinency, in elderly patients after rectal-cancer surgery.

Methods

All patients who underwent elective rectal surgery with anastomosis for rectal cancer between December 2008 and June 2012 at two Dutch hospitals were eligible for inclusion. The Wexner and the fecal incontinence quality of life (FIQoL) scores were collected. Young (<70 years of age) and elderly (≥70 years of age) patients were compared.

Results

Seventy-nine patients were included, of whom 19 were elderly patients (24.1%). All diverting stomas that had been placed (n = 60, 75.9%) had been closed at the time of the study. There were no differences in Wexner or FIQoL scores between the young and the elderly patients. Also, there were no differences between patients without a diverting stoma and patients in whom bowel continuity had been restored. Elderly females had significantly worse scores on the FIQoL subscales of coping/behavior (P = 0.043) and depression/self-perception (P = 0.004) than young females. Elderly females scored worse on coping/behavior (P = 0.010) and depression/self-perception (P = 0.036) than elderly males. Young and elderly males had comparable scores.

Conclusion

Quality of life with regard to fecal incontinency is worse in elderly females after sphincter-preserving surgery for rectal cancer. Patients should be informed of this impact, and a definite stoma may be considered in this patient group.

Citations

Citations to this article as recorded by

Analyzing quality of life after low anterior resection for rectal cancer
Seyed Mostafa Meshkati Yazd, Reza Shahriarirad, Shayan Almasi, Darioush Naddaffard, Saman Sheikhi, Imana Mosayebi, Kimia Goudarzi, Seyed Mohsen Ahmadi Tafti, Behnam Behboudi, Alireza Kazemeini, Mohammad Reza Keramati
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Patient-reported Bowel Function and Bowel-related Quality of Life After Pelvic Radiation for Rectal Adenocarcinoma: The Impact of Radiation Fractionation and Surgical Resection
Michael K. Rooney, Brian De, Kelsey Corrigan, Grace L. Smith, Cullen Taniguchi, Bruce D. Minsky, Ethan B. Ludmir, Eugene J. Koay, Prajnan Das, Albert C. Koong, Oliver Peacock, George Chang, Y. Nancy You, Van K. Morris, Graciela Nogueras-González, Emma B.
Clinical Colorectal Cancer.2023; 22(2): 211. CrossRef
Functional outcomes and local control are acceptable following hand‐sewn colo‐anal anastomoses for rectal cancer: Results of long‐term follow‐up
David Hudson, Fiona Entriken, Rupert Hodder, Michael Warner
ANZ Journal of Surgery.2022; 92(3): 390. CrossRef
Functional Bowel Complaints and the Impact on Quality of Life After Colorectal Cancer Surgery in the Elderly
Stijn H. J. Ketelaers, Maarten van Heinsbergen, Ricardo G. Orsini, F. Jeroen Vogelaar, Joop L. M. Konsten, Grard A. P. Nieuwenhuijzen, Harm J. T. Rutten, Jacobus W. A. Burger, Johanne G. Bloemen
Frontiers in Oncology.2022;[Epub] CrossRef
Symptoms affecting quality of life after sphincter-saving rectal cancer surgery: A systematic review
Jennie Burch, Claire Taylor, Ana Wilson, Christine Norton
European Journal of Oncology Nursing.2021; 52: 101934. CrossRef
Functional outcomes after sphincter-preserving surgeries for low-lying rectal cancer: A review
Eun Jung Park, Seung Hyuk Baik
Precision and Future Medicine.2021; 5(4): 164. CrossRef
The Artificial Bowel Sphincter in the Treatment of Fecal Incontinence, Long-term Complications
Aart A. van der Wilt, Stéphanie O. Breukink, Rosel Sturkenboom, Laurents P. Stassen, Cornelius G. Baeten, Jarno Melenhorst
Diseases of the Colon & Rectum.2020; 63(8): 1134. CrossRef
Health-Related Quality of Life in Older Adults with Colorectal Cancer
Evan Lapinsky, Lillian C. Man, Amy R. MacKenzie
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Quality of life and anterior resection syndrome after surgery for mid to low rectal cancer: A cross-sectional study
Loris Trenti, Ana Galvez, Sebastiano Biondo, Alejandro Solis, Francesc Vallribera-Valls, Eloy Espin-Basany, Alvaro Garcia-Granero, Esther Kreisler
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Late assessment of quality of life in patients with rectal carcinoma: comparison between sphincter preservation and definitive colostomy
Mariane Messias Reis Lima Silva, Samuel Aguiar Junior, Juliana de Aguiar Pastore, Érica Maria Monteiro Santos, Fábio de Oliveira Ferreira, Ranyell Matheus S. B. Spencer, Vinicius F. Calsavara, Wilson Toshihiko Nakagawa, Ademar Lopes
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Chirurgische Therapie des Karzinoms des unteren Rektumdrittels
A. D. Rink
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Quality of Life After a Low Anterior Resection in Elderly Patients
Byung Chun Kim
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Erratum

Erratum: Marieke S. Walma, Verena N. N. Kornmann, Djamila Boerma, Marnix A. J. de Roos, Henderik L. van Westreenen; Ann Coloproctol. 2015;31(4):167-167. Published online August 31, 2015; DOI: https://doi.org/10.3393/ac.2015.31.4.167

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PDF

Original Article

Predictors of Fecal Incontinence and Related Quality of Life After a Total Mesorectal Excision With Primary Anastomosis for Patients With Rectal Cancer: Marieke S. Walma, Verena N. N. Kornmann, Djamila Boerma, Marnix A. J. de Roos, Henderik L. van Westreenen; Ann Coloproctol. 2015;31(1):23-28. Published online February 28, 2015; DOI: https://doi.org/10.3393/ac.2015.31.1.23

7,339 View
48 Download
44 Web of Science
40 Citations

Abstract PDF

Purpose

After total mesorectal excision (TME) with primary anastomosis for patients with rectal cancer, the quality of life (QoL) may be decreased due to fecal incontinence. This study aimed to identify predictors of fecal incontinence and related QoL.

Methods

Patients who underwent TME with primary anastomosis for rectal cancer between December 2008 and June 2012 completed the fecal incontinence quality of life scale (FIQoL) and Wexner incontinence score. Factors associated with these scores were identified using a linear regression analysis.

Results

A total of 80 patients were included. Multivariate analysis identified a diverting ileostomy (n = 58) as an independent predictor of an unfavorable outcome on the FIQoL subscale coping/behavior (P = 0.041). Ileostomy closure within and after 3 months resulted in median Wexner scores of 5.0 (interquartile range [IQR], 2.5-8.0) and 10.5 (IQR, 6.0-13.8), respectively (P < 0.001). The median FIQoL score was 15.0 (IQR, 13.1-16.0) for stoma closure within 3 months versus 12.0 (IQR, 10.5-13.9) for closure after 3 months (P = 0.001).

Conclusion

A diverting ileostomy is a predictor for an impaired FIQoL after a TME for rectal cancer. Stoma reversal within 3 months showed better outcomes than reversal after 3 months. Patients with a diverting ileostomy should be informed about the impaired QoL, even after stoma closure.

Citations

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