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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
- 7,386 View
- 60 Download
- 14 Web of Science
- 14 Citations
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Abstract
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.
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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
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?
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
- Medical versus surgical causes of death following colorectal resection: a Queensland Audit of Surgical Mortality (QASM) study
- 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
- 8,006 View
- 66 Download
- 14 Web of Science
- 14 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.
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Citations
Citations to this article as recorded by- Four clinical dilemmas in surgical decision making for low rectal cancer
Amine Souadka, Urs Giger-Pabst, Mehdi Ouaissi
Discover Oncology.2026;[Epub] CrossRef - Bowel dysfunction after minimally invasive sphincter-preserving surgery for rectal cancer: A prospective study of prevalence, associated factors and quality of life
Kuppusamy Senthamizhselvan, RV Chandra Mamidala, Pazhanivel Mohan, Raja Kalayarasan
Journal of Minimal Access Surgery.2026;[Epub] CrossRef - 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
Irish Journal of Medical Science (1971 -).2024; 193(6): 2643. CrossRef - 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
Current Oncology Reports.2019;[Epub] CrossRef - 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
European Journal of Surgical Oncology.2018; 44(7): 1031. CrossRef - 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
International Journal of Colorectal Disease.2018; 33(8): 1039. CrossRef - Chirurgische Therapie des Karzinoms des unteren Rektumdrittels
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coloproctology.2017; 39(6): 411. CrossRef - Quality of Life After a Low Anterior Resection in Elderly Patients
Byung Chun Kim
Annals of Coloproctology.2016; 32(1): 5. CrossRef
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