Annals of Coloproctology

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Malignant disease, Rectal cancer,Prognosis and adjuvant therapy

Effect of Age on Laparoscopic Surgery and Postoperative Chemotherapy in Elderly Patients With Colorectal Cancer: Hyun Hee Kim, Myong Hoon Ihn, Yun Hee Lee, Jihyoun Lee, Sangchul Yun, Sung Woo Cho; Ann Coloproctol. 2020;36(4):229-242. Published online January 31, 2020; DOI: https://doi.org/10.3393/ac.2019.10.03

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Purpose
We aimed to evaluate the postoperative complications of laparoscopic colorectal cancer (CRC) surgery and the adverse events of postoperative chemotherapy in elderly patients compared to younger patients and to identify the factors influencing the termination of postoperative chemotherapy.
Methods
Between June 2015 and May 2018, 188 patients with CRC underwent laparoscopic surgery with curative intent. Patients aged ≥ 70 were defined as elderly. Postoperative complications and adverse events of chemotherapy were assessed by using the Clavien-Dindo classification and the Common Terminology Criteria for Adverse Events, respectively. The clinicopathological factors were analyzed retrospectively.
Results
Seventy-eight patients were considered elderly with a mean age of 77.5 ± 5.5 years. Overall postoperative complications occurred in 68 patients (36.2%). Age and primary tumor location were independent predictors of overall postoperative complications. Smoking history was the only independent predictor of major postoperative complications. Of 113 patients who were recommended postoperative chemotherapy, 90 patients (79.6%) received postoperative chemotherapy. Overall adverse events occurred in 40 patients (44.4%). The American Society of Anesthesiologists physical status classification and chemotherapy regimen were significantly associated with overall adverse events. The chemotherapy regimen was the only factor significantly associated with severe adverse events. Of 90 patients, postoperative chemotherapy could not be completed in 11 (12.2%). Age was the only factor significantly associated with stopping postoperative chemotherapy (P = 0.003).
Conclusion
This study shows that laparoscopic CRC surgery and postoperative chemotherapy were feasible in elderly patients. Further efforts are needed to ensure that elderly patients have the opportunity to make informed decisions regarding postoperative chemotherapy.

Citations

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Single-incision laparoscopic surgery with transabdominal retroperitoneal approach (SILS-TRPA): a novel surgical strategy for sigmoid colon/upper rectal cancer
Qijun Lv, Pengcheng Ye, Jin Tang, Qinyuan Wang, Junyi Li, Junsong Yang, Jingjing Chen, Xinyu Wang, Ruijie Lin, Hongshen Huang, Lei Zheng, Tianwen Yu, Hailin Gan, Yuhang Liu, Lang Luo, Shoujiang Wei
International Journal of Surgery.2026; 112(4): 9015. CrossRef
Outcome of robotic colon surgery in older patients with colon cancer
Ellen Van Eetvelde, Manu Verweirder, Lore Decoster, Daniel Jacobs-Tulleneers-Thevissen
Journal of Geriatric Oncology.2025; 16(3): 102205. CrossRef
Survival Benefits of Postoperative Chemotherapy in Patients With Colorectal Mucinous Adenocarcinoma: An Analysis Utilizing Propensity Score Matching From the Surveillance, Epidemiology, and End Results Database
Jun Rong, Wensheng Deng
The American Surgeon™.2024; 90(11): 2969. CrossRef
Nutritional Status Indicators Predict Tolerability to Adjuvant Chemotherapy in Patients with Stage II/III Rectal Cancer Undergoing Neoadjuvant Chemoradiotherapy
Shinya Abe, Hiroaki Nozawa, Kazuhito Sasaki, Koji Murono, Shigenobu Emoto, Yuichiro Yokoyama, Hiroyuki Matsuzaki, Yuzo Nagai, Takahide Shinagawa, Hirofumi Sonoda, Soichiro Ishihara
Digestion.2024; 105(5): 345. CrossRef
Abdominal Aortic Calcification as a Predictor of Incomplete Adjuvant Chemotherapy in Stage III Colorectal Cancer: A Retrospective Cohort Study
Kouki Imaoka, Manabu Shimomura, Hiroshi Okuda, Takuya Yano, Shintaro Akabane, Masahiro Ohira, Yuki Imaoka, Tetsuya Mochizuki, Minoru Hattori, Hideki Ohdan
Cureus.2024;[Epub] CrossRef
Effect of continuous wound infiltration on patients using intravenous patient-controlled analgesia for pain management after reduced-port laparoscopic colorectal surgery
Hyeon Deok Choi, Sung Uk Bae
Annals of Coloproctology.2024; 40(6): 564. CrossRef
Differences in prognosis and underuse of adjuvant chemotherapy between elderly and non‐elderly patients in stage III colorectal cancer
Takuya Shiraishi, Hiroomi Ogawa, Ikuma Shioi, Naoya Ozawa, Katsuya Osone, Takuhisa Okada, Makoto Sohda, Ken Shirabe, Hiroshi Saeki
Annals of Gastroenterological Surgery.2023; 7(1): 91. CrossRef
Clinical outcomes and cost comparison of laparoscopic versus open surgery in elderly colorectal cancer patients over 80 years
Aik Yong Chok, Ivan En-Howe Tan, Yun Zhao, Madeline Yen Min Chee, Hui Lionel Raphael Chen, Kwok Ann Ang, Marianne Kit Har Au, Emile John Kwong Wei Tan
International Journal of Colorectal Disease.2023;[Epub] CrossRef
Association between social background and implementation of postoperative adjuvant chemotherapy for older patients undergoing curative resection of colorectal cancers, sub-analysis of the HiSCO-04 study
Tomoaki Bekki, Manabu Shimomura, Yasufumi Saito, Masahiro Nakahara, Tomohiro Adachi, Satoshi Ikeda, Yosuke Shimizu, Masatoshi Kochi, Yasuyo Ishizaki, Masanori Yoshimitsu, Yuji Takakura, Wataru Shimizu, Daisuke Sumitani, Shinya Kodama, Masahiko Fujimori, M
International Journal of Colorectal Disease.2023;[Epub] CrossRef
Operative and Survival Outcomes of Robotic-Assisted Surgery for Colorectal Cancer in Elderly and Very Elderly Patients: A Study in a Tertiary Hospital in South Korea
Hugo Cuellar-Gomez, Siti Mayuha Rusli, María Esther Ocharan-Hernández, Tae-Hoon Lee, Guglielmo Niccolò Piozzi, Seon-Hahn Kim, Cruz Vargas-De-León, Yazhou He
Journal of Oncology.2022; 2022: 1. CrossRef
Multidisciplinary treatment strategy for early colon cancer
Gyung Mo Son, Su Bum Park, Tae Un Kim, Byung-Soo Park, In Young Lee, Joo-Young Na, Dong Hoon Shin, Sang Bo Oh, Sung Hwan Cho, Hyun Sung Kim, Hyung Wook Kim
Journal of the Korean Medical Association.2022; 65(9): 558. CrossRef
Multidisciplinary Treatment Strategy for Early Colon Cancer: A Review-An English Version
Gyung Mo Son, Su Bum Park, Tae Un Kim, Byung-Soo Park, In Young Lee, Joo-Young Na, Dong Hoon Shin, Sang Bo Oh, Sung Hwan Cho, Hyun Sung Kim, Hyung Wook Kim
Journal of the Anus, Rectum and Colon.2022; 6(4): 203. CrossRef
Adjuvant Chemotherapy in Elderly Colorectal Cancer Patients
Bengt Glimelius, Erik Osterman
Cancers.2020; 12(8): 2289. CrossRef

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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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.

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

Safety and Feasibility of a Laparoscopic Colorectal Cancer Resection in Elderly Patients: Duck Hyoun Jeong, Hyuk Hur, Byung Soh Min, Seung Hyuk Baik, Nam Kyu Kim; Ann Coloproctol. 2013;29(1):22-27. Published online February 28, 2013; DOI: https://doi.org/10.3393/ac.2013.29.1.22

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Abstract PDF

Purpose

The aim of this study is to assess the effects of age on the short-term outcomes of a laparoscopic resection of colorectal cancer in elderly (≥75 years old), as compared with younger (<75 years old), patients.

Methods

A retrospective analysis of patients who underwent laparoscopic surgery for colorectal cancer between January 2007 and December 2009 was performed. There were two groups: age <75 years old (group A) and age ≥75 years old (group B). The perioperative outcomes between group A and group B were compared.

Results

The study included 824 patients in group A and 92 patients in group B. The body mass index (BMI) and the American Society of Anesthesiologists (ASA) score were significantly different between group B and group A (BMI: 22.5 vs. 23.5, P = 0.002; ASA score: 1.88 vs. 1.48, P = 0.001). Mean operating times were similar between the groups (325.4 minutes vs. 351.6 minutes, P = 0.07). We observed a higher overall complication rate in group B than in group A (12.0% vs. 6.2%, P = 0.047), but the number of severe complications of Accordion Severity Classification ≥3 (those that required an invasive procedure) was not significantly different between the two groups (6.5% vs. 3.4%, P = 0.142). There was no significant difference in the length of hospital stay (13.0 days vs. 12.0 days, P = 0.053).

Conclusion

Although the elderly patients had a significantly higher overall postoperative complication rate, no significant difference was seen in either the number of severe complications of Accordion Severity Classification ≥3 or in the length of hospital stay. A laparoscopic colorectal cancer resection in elderly patients, especially those aged 75 years or older, is safe and feasible.

Citations

Citations to this article as recorded by

Evaluation of Laparoscopic Colorectal Resection Among Elderly Individuals With Colorectal Malignancy: A Single-center Retrospective Analysis
Yanru Zhang, Tufeng Chen, Xiaofeng Yang, Yiquan Li, Purun Lei
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2024; 34(3): 281. CrossRef
Risk Factors for Postoperative Paralytic Ileus in Advanced-age Patients after Laparoscopic Colorectal Surgery: A Retrospective Study of 124 Consecutive Patients
Takaaki Fujimoto, Tatsuya Manabe, Kumpei Yukimoto, Yasuhiro Tsuru, Hiroshi Kitagawa, Keiichiro Okuyama, Shin Takesue, Keita Kai, Hirokazu Noshiro
Journal of the Anus, Rectum and Colon.2023; 7(1): 30. CrossRef
Laparoscopic rectal cancer resection yields comparable clinical and oncological results with shorter hospital stay compared to open access: a 5-year national cohort
Elisabeth Myrseth, Petter Fosse Gjessing, Linn Såve Nymo, Hartwig Kørner, Jan Terje Kvaløy, Stig Norderval
International Journal of Colorectal Disease.2023;[Epub] CrossRef
Effect of intraoperative blood loss on postoperative complications and prognosis of patients with colorectal cancer: A meta‑analysis
Zi-Wei Li, Xin-Peng Shu, Ze-Lin Wen, Fei Liu, Xu-Rui Liu, Quan Lv, Xiao-Yu Liu, Wei Zhang, Dong Peng
Biomedical Reports.2023;[Epub] CrossRef
Lower conversion rate with robotic assisted rectal resections compared with conventional laparoscopy; a national cohort study
Elisabeth Myrseth, Linn Såve Nymo, Petter Fosse Gjessing, Hartwig Kørner, Jan Terje Kvaløy, Stig Norderval
Surgical Endoscopy.2022; 36(5): 3574. CrossRef
Age and comorbidities do not affect short-term outcomes after laparoscopic rectal cancer resection in elderly patients. A multi-institutional cohort study in 287 patients
Roberto Peltrini, Nicola Imperatore, Filippo Carannante, Diego Cuccurullo, Gabriella Teresa Capolupo, Umberto Bracale, Marco Caricato, Francesco Corcione
Updates in Surgery.2021; 73(2): 527. CrossRef
Perioperative and oncologic outcomes in young and octogenarian patients with colorectal cancer: a comparison at the extremes
Dedrick Kok Hong Chan, Sze Wai Leong, Christopher Hang Liang Keh
Langenbeck's Archives of Surgery.2021; 406(7): 2399. CrossRef
Decreasing Postoperative Pulmonary Complication Following Laparoscopic Surgery in Elderly Individuals with Colorectal Cancer: A Competing Risk Analysis in a Propensity Score–Weighted Cohort Study
Yih-Jong Chern, Jeng-Fu You, Ching-Chung Cheng, Jing-Rong Jhuang, Chien-Yuh Yeh, Pao-Shiu Hsieh, Wen-Sy Tsai, Chun-Kai Liao, Yu-Jen Hsu
Cancers.2021; 14(1): 131. CrossRef
Short- and long-term outcomes of laparoscopic surgery for colorectal cancer in the elderly aged over 80 years old versus non-elderly: a retrospective cohort study
Yoshitake Ueda, Norio Shiraishi, Takahide Kawasaki, Tomonori Akagi, Shigeo Ninomiya, Hidefumi Shiroshita, Tsuyoshi Etoh, Masafumi Inomata
BMC Geriatrics.2020;[Epub] CrossRef
Short-term outcomes of laparoscopic surgery for colorectal cancer in the elderly versus non-elderly: a systematic review and meta-analysis
Nobuaki Hoshino, Yudai Fukui, Koya Hida, Yoshiharu Sakai
International Journal of Colorectal Disease.2019; 34(3): 377. CrossRef
Outcomes of laparoscopic surgery for pT3/pT4 colorectal cancer in young vs. old patients
Gabriele Bellio, Marina Troian, Arianna Pasquali, Nicolò de Manzini
Minerva Chirurgica.2019;[Epub] CrossRef
Long-term outcomes of colorectal endoscopic submucosal dissection in elderly patients
Yoshifumi Takahashi, Ken-ichi Mizuno, Kazuya Takahashi, Hiroki Sato, Satoru Hashimoto, Manabu Takeuchi, Masaaki Kobayashi, Junji Yokoyama, Yuichi Sato, Shuji Terai
International Journal of Colorectal Disease.2017; 32(4): 567. CrossRef
Results of surgical treatment of colorectal cancer in nonagenarian patients
Arthur Manoel Braga de Albuquerque Gomes, Fábio Lopes de Queiroz, Rodrigo de Almeida Paiva
Journal of Coloproctology.2017; 37(04): 285. CrossRef
Evaluation of short-term outcomes of laparoscopic-assisted surgery for colorectal cancer in elderly patients aged over 75 years old: a multi-institutional study (YSURG1401)
Keisuke Kazama, Toru Aoyama, Tsutomu Hayashi, Takanobu Yamada, Masakatsu Numata, Shinya Amano, Mariko Kamiya, Tsutomu Sato, Takaki Yoshikawa, Manabu Shiozawa, Takashi Oshima, Norio Yukawa, Yasushi Rino, Munetaka Masuda
BMC Surgery.2017;[Epub] CrossRef
Laparoscopic Surgery for Rectal Cancer after Preoperative Chemoradiation in Elderly Patients
Je-Min Choi, Seung-Hun Lee, Seung-Hyun Lee, Byung-Kwon Ahn
The Journal of Minimally Invasive Surgery.2017; 20(3): 108. CrossRef
Elderly patients have more infectious complications following laparoscopic colorectal cancer surgery
C. L. Kvasnovsky, K. Adams, M. Sideris, J. Laycock, A. K. Haji, A. Haq, J. Nunoo‐Mensah, S. Papagrigoriadis
Colorectal Disease.2016; 18(1): 94. CrossRef
Laparoscopic surgery for patients with colorectal cancer produces better short‐term outcomes with similar survival outcomes in elderly patients compared to open surgery
Soo Yun Moon, Sohee Kim, Soo Young Lee, Eon Chul Han, Sung‐Bum Kang, Seung‐Yong Jeong, Kyu Joo Park, Jae Hwan Oh
Cancer Medicine.2016; 5(6): 1047. CrossRef
Short- and long-term outcomes of laparoscopic surgery for colorectal cancer in the elderly: A prospective cohort study
Katsuji Tokuhara, Kazuyoshi Nakatani, Yosuke Ueyama, Kazuhiko Yoshioka, Masanori Kon
International Journal of Surgery.2016; 27: 66. CrossRef
Impact of intraoperative blood loss on morbidity and survival after radical surgery for colorectal cancer patients aged 80 years or older
Ryosuke Okamura, Koya Hida, Suguru Hasegawa, Yoshiharu Sakai, Madoka Hamada, Masayoshi Yasui, Takao Hinoi, Masahiko Watanabe
International Journal of Colorectal Disease.2016; 31(2): 327. CrossRef
Is laparoscopic surgery really effective for the treatment of colon and rectal cancer in very elderly over 80 years old? A prospective multicentric case–control assessment
Francesco Roscio, Luigi Boni, Federico Clerici, Paolo Frattini, Elisa Cassinotti, Ildo Scandroglio
Surgical Endoscopy.2016; 30(10): 4372. CrossRef
Age Over 80 is a Possible Risk Factor for Postoperative Morbidity After a Laparoscopic Resection of Colorectal Cancer
Taekhyun Kang, Hyung Ook Kim, Hungdai Kim, Ho-Kyung Chun, Won Kon Han, Kyung Uk Jung
Annals of Coloproctology.2015; 31(6): 228. CrossRef

POSSUM, P-POSSUM, and Cr-POSSUM Scoring Systems as Predictors of Postoperative Morbidity and Mortality in Elderly Colorectal Cancer Patients.: Sung, Nak Song , Choi, In Seok , Choi, Won Jun; J Korean Soc Coloproctol. 2009;25(6):423-428.; DOI: https://doi.org/10.3393/jksc.2009.25.6.423

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Abstract PDF: PURPOSE
The Physiological and Operative Severity Score for the enumeration of Morbidity and Mortality (POSSUM), the Portsmouth-POSSUM (P-POSSUM), and the colorectal-POSSUM (Cr-POSSUM) are relative scoring systems for the prediction of postoperative morbidity and mortality. This study is designed to evaluate the usefulness of each scoring system in elderly colorectal cancer patients undergoing major colorectal surgery. METHODS: From January 2000 to May 2008, the authors retrospectively analyzed the medical records of 251 elderly colorectal cancer patients who had undergone surgery. Collected data were analyzed using the Mann-Whitney U-test, a risk stratification analysis, and a receiver-operator characteristic (ROC) curve to evaluate the usefulness and the accuracy of each scoring system. RESULTS: All the predicted morbidity and mortality rates calculated by using the three POSSUM systems were higher than the observed morbidity and mortality rates. A risk stratification analysis showed a considerable correlation in risk prediction between the observed data and the calculated data. The ROC curves showed that all three POSSUM scoring systems had quite high accuracies as predictors of postoperative morbidity and mortality. POSSUM and P-POSSUM were more accurate than Cr-POSSUM. CONCLUSION: All three scoring systems have a tendency for overestimation. The accuracies of POSSUM, P-POSSUM, and Cr-POSSUM as predictors are acceptance, and POSSUM and P-POSSUM are more accurate than Cr-POSSUM for prediting postoperative morbidity and mortality.

Clinical Analysis of Appendicitis in the Elderly Over 60 Years of Age.: Kim, Il Gun , Heo, Tae Gil , Lee, Jung Min , Choi, Pyong Wha , Park, Je Hoon , Lee, Myung Soo , Kim, Chul Nam , Chang, Surk Hyo; J Korean Soc Coloproctol. 2007;23(6):441-447.; DOI: https://doi.org/10.3393/jksc.2007.23.6.441

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Abstract PDF

PURPOSE
As average life expectancies are prolonged, the elderly population is steadily increasing. The increasing number of elderly persons has been accompanied by cases of acute appendicitis in the elderly. In order to understand the clinical significance and to improve the treatment of elderly patients with appendicitis. we analyzed patients over 60 years of age with appendicitis.
METHODS
We retrospectively reviewed the medical records of 268 patients over 60 years of age who were pathologically diagnosed with appendicitis. We analyzed the patients' clinicopathologic factors and outcomes, dividing them into 3 age groups: 60~69, 70~79, 80 and over.
RESULTS
Of the 268 patients, there were 109 male and 159 female. The sex ratio was 1:1.46. The numbers of patients in each group were 169 (63.1%) in the 60-69 group, 73 (27.2%) in the 70~79 group, and 26 (9.7%) in the over 80 group. There was no difference in the leukocyte count and the time delay in surgical treatment between the groups. In the older groups, compared to the younger groups, there were more frequent paramedian and median incisions in the operation (P=0.02), a longer duration of postoperative admission (P=0.001) and starvation after the operation (P<0.001). In the pathologic findings, the gangrenous and abscess stages of appendicitis were more frequent in the older groups than in the younger groups (P<0.001).
CONCLUSIONS
Early aggressive diagnostic intervention, such as ultrasound and CT, is essential in managing appendicitis in elderly patients who complain of vague abdominal pain.

Citations

Citations to this article as recorded by

Ultrasonography of Appendicitis
Dae Hyun Kim
Clinical Ultrasound.2016; 1(1): 19. CrossRef

Laparoscopic Surgery for Colorectal Cancer in Elderly Patients.: Lee, Yoon Suk , Lee, In Kyu , Kang, Won Kyung , Cho, Hyun Min , Park, Jong Kyung , Oh, Seung Teak , Kim, Jun Gi , Kim, Young Ha; J Korean Soc Coloproctol. 2007;23(4):257-261.; DOI: https://doi.org/10.3393/jksc.2007.23.4.257

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Abstract PDF

PURPOSE
Elderly colorectal cancer patients may have increased surgical morbidity and mortality due to comorbidity and compromised cardiopulmonary reserves. The aim of this study is to compare the safety and the outcomes of laparoscopic surgery for colorectal cancer in patients of 70 years of age and older to those of patients younger than 70 years of age.
METHODS
From August 2004 to April 2006, the authors retrospectively analyzed the medical records of patients who underwent laparoscopic surgery for colorectal cancer.
RESULTS
The elderly group included 35 cases, and the younger group included 67 cases. The mean age of the elderly group was 74.4+/-4.1, and that of the younger group was 58.2+/-9.5. Sixty-three percent (63%) of the elderly group and 27% of the younger group had co- morbidity. The mean operation time in the elderly group was 299.9+/-121.0 minutes, and that in the younger group was 295.1+/-110.8 minutes. The mean number of harvested lymph nodes was 17.7+/-8.6 in the elderly group and 19.4+/-9.8 in the younger group. The day of diet start was the 4.1+/-0.6 postoperative day in the elderly group and the 4.4+/-1.4 day in the younger group. Hospital stay was 16.0+/-7.6 in the elderly group and 15.5+/-4.6 days in the younger group. There were no statistical differences in terms of operation time, number of harvested lymph nodes, blood loss at operation, day of flatus passing, diet start, hospital stay, and complications. There was no surgical mortality in either groups.
CONCLUSIONS
Laparoscopic surgery for colorectal cancer is a safe and effective treatment option in elderly patients.

Citations

Citations to this article as recorded by

Effects of Heated-Humidified Anesthetic Gas in the Elderly Patients with Colorectal Cancer during Laparoscopic Surgery: Randomized Controlled Trial
Hyo-Sun Park, Younhee Kang
Korean Journal of Adult Nursing.2018; 30(2): 206. CrossRef
Can Elderly Patients Older than 75 Years with Colorectal Cancer Tolerate Planned Laparoscopic Surgery?
Kang San Lee, Young Wan Kim, Joo Hee Kim, Hyun Jun Kwon, Ik Yong Kim
The Journal of Minimally Invasive Surgery.2012; 15(4): 126. CrossRef

Clinical Analysis of Acute Appendicitis in the Elderly.: An, Sang Su , Soh, Yoon Seop , Cho, Ik Haeng , Back, Hyeon Myeong , Lee, Seong Yeol; J Korean Soc Coloproctol. 2002;18(5):274-280.

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Abstract PDF: PURPOSE
Surgeons are confronted frequently with the diagnostic and therapeutic challenges in the cases of acute appendicitis in the elderly. Despite the improvements in management, the morbidity and mortality remain high. In order to verify contributing factors of high morbidity and mortality and establish more proper diagnostic and therapeutic strategies, we compared the clinical characteristics and outcomes of acute appendicitis in the elderly with those of younger people.
METHODS
We retrospectively reviewed medical records of 30 elderly and 248 younger people who were pathologically diagnosed as appendicitis after an appendectomy.
RESULTS
There was no difference in the rates of occurrence of right lower abdominal pain and tenderness between the two people. The rate of appendiceal perforation was significantly higher in the elderly. Prehospital delay was significantly longer in the elderly. Concomitant diseases were more prevalent in the elderly. The hospital stay was significantly longer and the rate of complication was relatively higher in the elderly also.
CONCLUSIONS
When a vague and unexplained abdominal discomfort occurs in the elderly, we should suspect and rule out acute appendicitis as the cause of the discomfort. Early aggressive diagnostic and therapeutic interventions are essential components in managing acute appendicitis in the elderly. In addition, perioperative evaluation and prophylactic measures for concomitant diseases are needed to decrease morbidity and mortality in the elderly.

A Clinical Analysis of Colorectal Cancer in Young and Elderly Patients.: Kim, Hyeong Rok , Kim, Young Jin , Lee, Jung Hun , Kim, Dong Yi , Kim, Shin Kon; J Korean Soc Coloproctol. 1998;14(2):199-208.

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Abstract PDF: Colorectal carcinoma in patients under 40 years and over 70 years of age is unusual but not rare. The prognosis of these two groups, compared with remainder of patients, is thought to be unfavorable. From Jan. 1981 to Dec. 1997, 541 patients with primary colorectal cancer who were treated by surgical resection were analyzed retrospectively. They were divided into three age groups according to the age at admission, i.e. under 40 years, over 70 years and between 40 and 69 years(control group). Among three age groups, sex ratio, tumor characteristics(size, location , depth of invasion, lymph node metastasis, liver metastasis, peritoneal metastasis, histopathologic classification, stage, DNA ploidy pattern), serum CEA level and survival were compared and analyzed. The results were as follows: 1) In the young patient group(52 cases), female predominence, large tumor size, high proportion of mucinous adenocarcinoma in histopathologic classification, more frequent metastasis to regional lymph node, frequent peritoneal metastasis and high incidence in tumor location at transverse colon were noted(p<0.05). 2) In the elderly group(69 cases), deep invasion of tumor(T4) was noted (p<0.05). In addition, among them, concomittent diseases were presented in 25 patients(36%). They were diabetes(8), cardiac arrhythmia(4), old myocardial infarction(2), liver cirrhosis(5), COPD(3), previous cancer(3). 3) The 5-year survival rates of the young patient group and that of elderly patient group were lower than that of the other(p<0.01). 4) There was no significant differences in liver metastasis, tumor stage, DNA ploidy pattern, serum CEA level among three age groups.

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