Annals of Coloproctology

Original Articles

Benign proctology,Complication,Biomarker & risk factor

Frequency and risk factors of severe postoperative bleeding after proctological surgery: a retrospective case-control study: Sarah Taieb, Patrick Atienza, Jean-David Zeitoun, Milad Taouk, Josée Bourguignon, Christian Thomas, Nabila Rabahi, Saliha Dahlouk, Anne-Carole Lesage, David Lobo, Isabelle Etienney; Ann Coloproctol. 2022;38(5):370-375. Published online July 27, 2021; DOI: https://doi.org/10.3393/ac.2021.00122.0017

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4 Citations

Purpose
The aim of this study was to assess frequency and risk factors of severe bleeding after proctological surgery requiring hemostatic surgery observed after publication of the French guidelines for anticoagulant and platelet-inhibitor treatment.
Methods
All patients who underwent proctological surgery between January 2012 and March 2017 in a referral center were included. Delay, severity of bleeding, and need for blood transfusion were recorded. Patients with severe postoperative bleeding were matched to controls at a 2:1 ratio adjusted on the operator, and the type of surgery.
Results
Among the 8,890 operated patients, 65 (0.7%) needed a postoperative hemostatic procedure in an operating room. The risk of a hemostatic surgery was significantly increased after hemorrhoidal surgery compared with other procedures (1.9% vs. 0.5%, P<10^–4) and was most frequent after Milligan-Morgan hemorrhoidectomy (2.5%). Mean bleeding time was 6.2 days and no bleeding occurred after day 15. Blood transfusion rate was 0.1%. Treatment with anticoagulants and platelet inhibitors were managed according to recommendations and did not increase the severity of bleeding. The risk of severe bleeding was significantly lower in active smokers vs. non-smokers in univariate (16.9% vs. 36.2%, P=0.007) and multivariate (odds ratio, 0.31; 95% confidence interval, 0.14–0.65) analysis whereas sex, age, and body mass were not significantly associated with bleeding.
Conclusion
Severe postoperative bleeding occurs in 0.7% of patients, but varies with type of procedure and is not affected by anticoagulant or antiplatelet treatment. These treatments given in accordance with the new guidelines do not increase the severity of postoperative bleeding.

Citations

Citations to this article as recorded by

Efficacy of Endoscopic Evaluation and Hemostatic Intervention for Post-hemorrhoidectomy Bleeding
Katsuhisa Ohashi, Katsuhide Ohashi, Akinori Sasaki, Kazuyoshi Ota, Kazutomo Kitagawa
Journal of the Anus, Rectum and Colon.2025; 9(1): 162. CrossRef
Evaluation of Clinical Manifestations of Hemorrhoidal Disease, Carried Out Surgeries and Prolapsed Anorectal Tissues: Associations with ABO Blood Groups of Patients
Inese Fišere, Valērija Groma, Šimons Svirskis, Estere Strautmane, Andris Gardovskis
Journal of Clinical Medicine.2023; 12(15): 5119. CrossRef
Sclerobanding in the treatment of second and third degree hemorrhoidal disease in high risk patients on antiplatelet/anticoagulant therapy without suspension: a pilot study
Francesco Pata, Luigi M. Bracchitta, Bruno Nardo, Gaetano Gallo, Giancarlo D’Ambrosio, Salvatore Bracchitta
Frontiers in Surgery.2023;[Epub] CrossRef
Principles of minimize bleeding and the transfusion of blood and its components in operated patients – surgical aspects
Tomasz Banasiewicz, Waldemar Machała, Maciej Borejsza Wysocki, Maciej Lesiak, Sebastian Krych, Małgorzata Lange, Piotr Hogendorf, Adam Durczyński, Jarosław Cwaliński, Tomasz Bartkowiak, Adam Dziki, Wojciech Kielan, Stanisław Kłęk, Łukasz Krokowicz, Krzysz
Polish Journal of Surgery.2023; 95(5): 14. CrossRef

Malignant disease,Prognosis and adjuvant therapy,Functional outcomes,Colorectal cancer,Postoperative outcome & ERAS

Clinical validation of implementing Enhanced Recovery After Surgery protocol in elderly colorectal cancer patients: Wooree Koh, Chul Seung Lee, Jung Hoon Bae, Abdullah Al-Sawat, In Kyu Lee, Hyeong Yong Jin; Ann Coloproctol. 2022;38(1):47-52. Published online July 21, 2021; DOI: https://doi.org/10.3393/ac.2021.00283.0040

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13 Web of Science
15 Citations

Abstract PDF Supplementary Material

Purpose
The aim of this study was to evaluate the safety and feasibility of applying enhanced recovery after surgery (ERAS) protocol in elderly colorectal cancer patients.
Methods
The medical records of patients who underwent elective colorectal cancer surgery at our institution, from January 2017 to December 2017, were reviewed. Patients were divided into 2 groups: the young group (YG, patients aged 70 and under 70 years) and the old group (OG, patients over 70 years old). Perioperative outcomes and length of hospital stay were compared between both groups.
Results
In total, 335 patients were enrolled; 237 were YG and 98 were OG. Despite the poorer baseline characteristics of OG, the perioperative outcomes were similar. Length of hospital stay was not different between the groups (YG, 5 days vs. OG, 5 days; P=0.320). When comparing the postoperative complications using the comprehensive complication index (CCI), there was no significant difference (YG, 8.0±13.2 vs. OG, 11.7±23.0; P=0.130). In regression analysis, old age (>70 years) was not a risk factor for high CCI in all patients. In multivariate analysis, C-reactive protein (CRP) level on postoperative day (POD) 3 to 4 was the only strong predictive factor for high CCI in elderly patients.
Conclusion
Implementing the ERAS protocol in patients aged >70 years is safe and feasible. High CRP (≥6.47 mg/dL) on POD 3 to 4 can be used as a safety index to postpone discharge in elderly patients.

Citations

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Perioperative outcomes of laparoscopic low anterior resection using ArtiSential® versus robotic approach in patients with rectal cancer: a propensity score matching analysis
I. K. Kim, C. S. Lee, J. H. Bae, S. R. Han, W. Alshalawi, B. C. Kim, I. K. Lee, D. S. Lee, Y. S. Lee
Techniques in Coloproctology.2024;[Epub] CrossRef
Challenging issues of implementing enhanced recovery after surgery programs in South Korea
Soo-Hyuk Yoon, Ho-Jin Lee
Anesthesia and Pain Medicine.2024; 19(1): 24. CrossRef
Effects of the enhanced recovery after surgery (ERAS) protocol on the postoperative stress state and short‐term complications in elderly patients with colorectal cancer
He Han, Rong Wan, Jixiang Chen, Xin Fan, LiWen Zhang
Cancer Reports.2024;[Epub] CrossRef
Sex Disparities in Rectal Cancer Surgery: An In-Depth Analysis of Surgical Approaches and Outcomes
Chungyeop Lee, In Ja Park
The World Journal of Men's Health.2024; 42(2): 304. CrossRef
Application of ERAS in older patients with gastric cancer
Kuanxuan You, He Han
Medicine.2024; 103(22): e38409. CrossRef
Clinical outcomes and future directions of enhanced recovery after surgery in colorectal surgery: a narrative review
Ji Hyeong Song, Minsung Kim
The Ewha Medical Journal.2024;[Epub] CrossRef
Correlation between inflammatory markers and enhanced recovery after surgery (ERAS) failure in laparoscopic colectomy
Ji Hyeong Song, Yoonsoo Shin, Kyung Ha Lee, Ji Yeon Kim, Jin Soo Kim
Surgery Today.2024;[Epub] CrossRef
Beyond the Operating Room: A Narrative Review of Enhanced Recovery Strategies in Colorectal Surgery
Hamed Ibrahim Hamed Albalawi, Rawshan Khalid A Alyoubi, Nawaf Mohsen Mubarak Alsuhaymi, Farha Abdullah K Aldossary, Alkathiry Abdulrahman Mohammed G, Fayez Mubarak Albishi, Jumana Aljeddawi, Fedaa Ahmed Omar Najm, Neda Ahmed Najem, Mohamed Mirza Ali Alma
Cureus.2024;[Epub] CrossRef
Impact of Early Oral Feeding on Postoperative Outcomes after Elective Colorectal Surgery: A Systematic Review and Meta-Analysis
Soo Young Lee, Eon Chul Han
Digestive Surgery.2024; : 1. CrossRef
Enhanced recovery after colorectal surgery is a safe and effective pathway for older patients: a pooling up analysis
Xu-Rui Liu, Xiao-Yu Liu, Bin Zhang, Fei Liu, Zi-Wei Li, Chao Yuan, Zheng-Qiang Wei, Dong Peng
International Journal of Colorectal Disease.2023;[Epub] CrossRef
Effects of preoperative bicarbonate and lactate levels on short-term outcomes and prognosis in elderly patients with colorectal cancer
Xiao-Yu Liu, Zi-Wei Li, Bin Zhang, Fei Liu, Wei Zhang, Dong Peng
BMC Surgery.2023;[Epub] CrossRef
The Latest Results and Future Directions of Research for Enhanced Recovery after Surgery in the Field of Colorectal Surgery
Min Ki Kim
The Ewha Medical Journal.2023;[Epub] CrossRef
Influence of the COVID-19 Pandemic on the Treatment Patterns and Outcomes of Colorectal Cancer
In Ja Park
The Ewha Medical Journal.2023;[Epub] CrossRef
Future direction of Enhanced Recovery After Surgery (ERAS) program in colorectal surgery
In Ja Park
Annals of Coloproctology.2022; 38(1): 1. CrossRef
Implementation and improvement of Enhanced Recovery After Surgery protocols for colorectal cancer surgery
Bo Yoon Choi, Jung Hoon Bae, Chul Seung Lee, Seung Rim Han, Yoon Suk Lee, In Kyu Lee
Annals of Surgical Treatment and Research.2022; 102(4): 223. CrossRef

Surgical Outcomes and Risk Factors in Patients Who Underwent Emergency Colorectal Surgery: Dai Sik Jeong, Young Hun Kim, Kyung Jong Kim; Ann Coloproctol. 2017;33(6):239-244. Published online December 31, 2017; DOI: https://doi.org/10.3393/ac.2017.33.6.239

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11 Citations

Abstract PDF

Purpose

Emergency colorectal surgery has high rates of complications and mortality because of incomplete bowel preparation and bacterial contamination. The authors aimed to evaluate the surgical outcomes and the risk factors for the mortality and the complication rates of patients who underwent emergency surgery to treat colorectal diseases.

Methods

This is a prospective study from January 2014 to April 2016, and the results are based on a retrospective analysis of the clinical results for patients who underwent emergency colorectal surgery at Chosun University Hospital.

Results

A total of 99 patients underwent emergency colorectal surgery during the study period. The most frequent indication of surgery was perforation (75.8%). The causes of disease were colorectal cancer (19.2%), complicated diverticulitis (21.2%), and ischemia (27.2%). There were 27 mortalities (27.3%). The major morbidity was 39.5%. Preoperative hypotension and perioperative blood transfusion were independent risk factors for both morbidity and mortality.

Conclusion

These results revealed that emergency colorectal surgeries are associated with significant morbidity and mortality. Furthermore, the independent risk factors for both morbidity and mortality in such patiients were preoperative hypotension and perioperative transfusion.

Citations

Citations to this article as recorded by

Effects of the COVID‐19 pandemic on short‐term postoperative outcomes for colorectal perforation: A nationwide study in Japan based on the National Clinical Database
Shimpei Ogawa, Hideki Endo, Masahiro Yoshida, Tomomitsu Tsuru, Michio Itabashi, Hiroyuki Yamamoto, Yoshihiro Kakeji, Hideki Ueno, Yuko Kitagawa, Taizo Hibi, Akinobu Taketomi, Norihiko Ikeda, Masaki Mori
Annals of Gastroenterological Surgery.2024; 8(3): 450. CrossRef
Effects of surgeon specialization on the outcome of emergency colorectal surgery
Nahar A. Alselaim, Ohood H. AlAamer, Mohammed M. Almalki, Abdualziz A. Al-osail, Sultanah F. Bin Gheshayan
Annals of Medicine & Surgery.2024; 86(12): 7010. CrossRef
Association between Intraoperative Early Warning Score and Mortality and In-Hospital Stay in Lower Gastrointestinal Spontaneous Perforation
Kazuya Takada, Yusuke Nagamine, Akira Ishii, Yan Shuo, Takumi Seike, Hanako Horikawa, Kentaro Matsumiya, Tetsuya Miyashita, Takahisa Goto, Ronald G. Pearl
Anesthesiology Research and Practice.2023; 2023: 1. CrossRef
Sigmoid colon cancer presenting as a left inguinal hernia: a case report
Mohammad E. Al Mohtasib, Mohammad N. Emar, Anan I. Al-jabari, Taima M. Aljabari, Islam H. Karajeh, Qutaiba Y. Al Jawabrah, Raghad M. Dghaish, Fahmi Jubran, Shadi Ruzayqat
Annals of Medicine & Surgery.2023; 85(11): 5653. CrossRef
Factors associated with 30-day mortality and morbidity in patients undergoing emergency colorectal surgery
Nahar A. Alselaim, Muhannad Abdulrahman Alsemari, Mesnad Alyabsi, Abrar M. Al-Mutairi
Annals of Saudi Medicine.2023; 43(6): 364. CrossRef
Efficiency of pre-operative preparation of intestines at treatment of sharp intestinal impassability tumoral genesis
H. Sh. Nazarov, Sh. К. Nazarov, N. Sh. Hasanov
Health care of Tajikistan.2022; (2): 59. CrossRef
Fluid management for critical patients undergoing urgent colectomy
Fabian Grass, Basile Pache, Fabio Butti, Josep Solà, Dieter Hahnloser, Nicolas Demartines, Martin Hübner
Journal of Evaluation in Clinical Practice.2020; 26(1): 109. CrossRef
Emergency surgery for gastrointestinal cancer: A nationwide study in Japan based on the National Clinical Database
Nobuaki Hoshino, Hideki Endo, Koya Hida, Nao Ichihara, Yoshimitsu Takahashi, Hiroshi Hasegawa, Toshimoto Kimura, Yuko Kitagawa, Yoshihiro Kakeji, Hiroaki Miyata, Takeo Nakayama, Yoshiharu Sakai
Annals of Gastroenterological Surgery.2020; 4(5): 549. CrossRef
Gestione delle complicanze infettive intra-addominali e delle peritoniti postoperatorie in chirurgia viscerale
A. Mancini, J. Abba, C. Arvieux
EMC - Tecniche Chirurgiche Addominale.2020; 26(4): 1. CrossRef
Tratamiento de las complicaciones infecciosas intraabdominales y de la peritonitis postoperatoria en cirugía visceral
A. Mancini, J. Abba, C. Arvieux
EMC - Técnicas Quirúrgicas - Aparato Digestivo.2020; 36(4): 1. CrossRef
Colonic stenting as a bridge to surgery in malignant large bowel obstruction: oncological outcomes
N. E. Donlon, M. E. Kelly, F. Narouz, P. H. McCormick, J. O. Larkin, B. J. Mehigan
International Journal of Colorectal Disease.2019; 34(4): 613. CrossRef

Outcome of Colorectal Surgery in Elderly Populations: Mostafa Shalaby, Nicola Di Lorenzo, Luana Franceschilli, Federico Perrone, Giulio P. Angelucci, Silvia Quareisma, Achille L. Gaspari, Pierpaolo Sileri; Ann Coloproctol. 2016;32(4):139-143. Published online August 31, 2016; DOI: https://doi.org/10.3393/ac.2016.32.4.139

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14 Citations

Abstract PDF

Purpose

The aim of this study is to investigate the impact of age on short-term outcomes after colorectal surgery in terms of the 30-day postoperative morbidity and mortality rates.

Methods

The subjects for the study were patients who had undergone colorectal surgery. Patients were divided into 2 groups according to age; groups A and B patients were ≥80 and <80 years old of age, respectively. Both groups were manually matched for body mass index, American Society of Anesthesiologists score, Charlson Comorbidity Index and procedure performed.

Results

A total of 200 patients, 91 men (45.5%) and 109 women (54.5%), were included in this retrospective study. These patients were equally divided into 2 groups. The mean ages were 85 years in group A (range, 80 to 104 years) and 55.3 years in group B (range, 13 to 79 years). The overall 30-day postoperative mortality rate was 1% of total 200 patients; both of these 2 patients were in group A. However, this observation had no statistical significance. No intraoperative complications were encountered in either group. The overall 30-day postoperative morbidity rate was 27% (54 of 200) for both groups. The 30-day postoperative morbidity rates in groups A and B were 28% (28 of 100) and 26% (26 of 100), respectively. However, these differences between the groups had no statistical significance importance.

Conclusion

Age alone should not be considered to be more of a contraindication or a worse predictor than other factors for the outcome after colorectal surgery on elderly patients.

Citations

Citations to this article as recorded by

Preoperative management in octogenarian patients with rectal cancer
Arthur M. Damasceno, Rubens Kesley, Marcus Valadão, Fabrício Braga, Cristiane A. D'Almeida, Marcos B. Pitombo
Heliyon.2025; 11(1): e41469. CrossRef
Predictors of complicated course of perioperative period in patients with rectal cancer and rectosigmoid junction
E. P. Kulikov, S. A. Mertsalov, N. I. Verkin, Yu. D. Kaminskiy, I. S. Pikushin
Experimental and Clinical Gastroenterology.2023; (10): 77. CrossRef
Oncological and surgical outcomes of radical surgery in elderly colorectal cancer patients with intestinal obstruction
Qingbiao Ma, Hongyu Li, Yujuan Jiang, Yingfei Wang, Jianwei Liang
Frontiers in Surgery.2023;[Epub] CrossRef
Efficiency of pre-operative preparation of intestines at treatment of sharp intestinal impassability tumoral genesis
H. Sh. Nazarov, Sh. К. Nazarov, N. Sh. Hasanov
Health care of Tajikistan.2022; (2): 59. CrossRef
Before-and-After Study of the First Four Years of the Enhanced Recovery after Surgery (ERAS®) Programme in Older Adults Undergoing Elective Colorectal Cancer Surgery
Cristina Martínez-Escribano, Francisco Arteaga Moreno, David Cuesta Peredo, Francisco Javier Blanco Gonzalez, Juan Maria De la Cámara-de las Heras, Francisco J. Tarazona Santabalbina
International Journal of Environmental Research and Public Health.2022; 19(22): 15299. CrossRef
Perioperative score for octogenarian patients eligible for rectal cancer surgery
Arthur Mota Damasceno, Rubens Kesley, Bruno Souza Paolino, Marcelo Rubens dos Santos do Amaral, Marcos Bettini Pitombo
Journal of Surgical Oncology.2021; 124(8): 1409. CrossRef
Prehabilitation: finally utilizing frailty screening data
Francesco Carli, Amal Bessissow, Rashami Awasthi, Sender Liberman
European Journal of Surgical Oncology.2020; 46(3): 321. CrossRef
Video‐assisted anal fistula treatment for complex anal fistula: a long‐term follow‐up study
G. Giarratano, M. Shalaby, C. Toscana, P. Sileri
Colorectal Disease.2020; 22(8): 939. CrossRef
New prognostic risk score for predicting in-hospital mortality in geriatric patients undergoing colorectal cancer surgery: U.S. Nationwide Inpatient Sample analysis
Xiaohong Zhao, Yunmei Yang, Haifeng Gu, Wenjing Zhou, Qin Zhang
Journal of Geriatric Oncology.2020; 11(8): 1250. CrossRef
Impact of ASA-score, age and learning curve on early outcome in the initiation phase of an oncological robotic colorectal program
Hülya Sarikaya, Tahar Benhidjeb, Sergiu I. Iosivan, Theodoros Kolokotronis, Christine Förster, Stephan Eckert, Ludwig Wilkens, Alaa Nasser, Sebastian Rehberg, Martin Krüger, Jan Schulte am Esch
Scientific Reports.2020;[Epub] CrossRef
Prediction of overall survival following colorectal cancer surgery in elderly patients
Isaac Seow-En, Winson Jianhong Tan, Sreemanee Raaj Dorajoo, Sharon Hui Ling Soh, Yi Chye Law, Soo Yeun Park, Gyu-Seok Choi, Wah Siew Tan, Choong Leong Tang, Min Hoe Chew
World Journal of Gastrointestinal Surgery.2019; 11(5): 247. 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
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
Colorectal Surgery in Elderly Patients
Byung Chun Kim
Annals of Coloproctology.2016; 32(4): 126. CrossRef

Comparative Study of Postoperative Complications in Patients With and Without an Obstruction Who Had Left-Sided Colorectal Cancer and Underwent a Single-Stage Operation After Mechanical Bowel Preparation: Sang Hun Jung, Jae Hwang Kim; Ann Coloproctol. 2014;30(6):251-258. Published online December 31, 2014; DOI: https://doi.org/10.3393/ac.2014.30.6.251

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5 Web of Science
3 Citations

Abstract PDF

Purpose

The purpose of this study is to compare postoperative complications for single-stage surgery after mechanical bowel preparation in patients who experienced obstruction and those who did not.

Methods

From 2000 to 2011, 1,224 patients underwent a single-stage operation for left colorectal cancer after bowel preparation. Nonobstruction (NOB) and obstruction (OB) colorectal cancer patients were 1,053 (86.0%) and 171 (14.0%), respectively. Postoperative morbidity and mortality were compared between groups.

Results

The OB group had poor preoperative conditions (age, white blood cell, hemoglobin, albumin level, and advanced tumor stage) compared with the NOB group (P < 0.05). Mean on-table lavage time for the OB group was 17.5 minutes (range, 14-60 minutes). Mean operation time for the OB group was statistically longer than that of the NOB group (OB: 210 minutes; range, 120-480 minutes vs. NOB: 180 minutes; range, 60-420 minutes; P < 0.001). Overall morbidity was similar between groups (NOB: 19.7% vs. OB: 23.4%, P = 0.259). Major morbidity was more common in the OB group than in the NOB group, but the difference was without significance (OB: 11.7% vs. NOB: 7.6%, P = 0.070). Postoperative death occurred in 16 patients (1.3%), and death in the OB group (n = 7) was significantly higher than it was in the NOB group (n = 9) (4.1% vs. 0.9%, P = 0.001). Twelve patients had surgical complications, which were the leading cause of postoperative death: postoperative bleeding in five patients and leakage in seven patients.

Conclusion

Postoperative morbidity for a single-stage operation for obstructive left colorectal cancer is comparable to that for NOB, regardless of poor conditions of the patient.

Citations

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Clinical characteristics and risk factors of post-operative intestinal flora disorder following laparoscopic colonic surgery: A propensity-score-matching analysis
Gan-Bin Li, Chen-Tong Wang, Xiao Zhang, Xiao-Yuan Qiu, Wei-Jie Chen, Jun-Yang Lu, Lai Xu, Bin Wu, Yi Xiao, Guo-Le Lin
World Journal of Gastrointestinal Surgery.2024; 16(5): 1259. CrossRef
Laparoscopic versus open surgery for obese patients with rectal cancer: a retrospective cohort study
Hiroyuki Matsuzaki, Soichiro Ishihara, Kazushige Kawai, Koji Murono, Kensuke Otani, Koji Yasuda, Takeshi Nishikawa, Toshiaki Tanaka, Tomomichi Kiyomatsu, Keisuke Hata, Hiroaki Nozawa, Hironori Yamaguchi, Toshiaki Watanabe
Surgery Today.2017; 47(5): 627. CrossRef
Surgical Treatment of Obstructed Left-Sided Colorectal Cancer Patients
Young Jin Kim
Annals of Coloproctology.2014; 30(6): 245. 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

4,295 View
34 Download
21 Citations

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

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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
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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
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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
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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
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The Characteristics of Colorectal Cancer in Patients Older than 80 Years.: Lee, Jae Myeong , Kim, Hee Cheol , Park, In Ja , Kim, Dae Dong , Yu, Chang Sik , Kim, Jin Cheon; J Korean Soc Coloproctol. 2007;23(6):490-496.; DOI: https://doi.org/10.3393/jksc.2007.23.6.490

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PURPOSE
The frequency of surgery for elderly Koreans with colorectal cancer has increased because of the current life expectancy rates. The purpose of this study is to identify the characteristics of colorectal cancer in very elderly patients, to determine the optimal treatment decision, and to evaluate the patients prognosis.
METHODS
Between 1989~2005, 181 patients (96 men and 85 women, median age 82) over the age of 80 with colorectal cancer underwent surgery at OO hospital, Korea. Medical records with these patients' co-morbidities, symptoms, clinico-pathologic characteristics, complications, survival, and other relevant data were obtained and analyzed retrospectively.
RESULTS
The principal clinical symptoms were bleeding (45.3%) and bowel habit change (40.9%). Of these patients, 126 had at least one preoperative co-morbidity, and hypertension (29.3%), and cardiac disease (16.0%) were common. Curative surgery was performed in 82.9% (n=150). Emergency surgery was performed in 6.1% (n=11), and the principal cause was obstruction. The most common location of the colorectal cancer was the rectum (39.8%). There were postoperative complications in 36.4% of the patients, including voiding difficulty (12.2%) and wound infection (9.9%). The thirty-day mortality rate was 0.6% (n=1). A preoperative, low PaO2 level significantly increased the incidence of postoperative complications (P=0.036). The five-year survival rate of the curative resection group was higher than that in the remaining patients (44.3% vs. 38.8%, P<0.001).
CONCLUSIONS
Although the preoperative morbidity was high in these very elderly patients, it could be lowered with strict patient management. In addition, these patients showed a relatively good survival rate. Therefore, we believe that major, curative, colorectal surgery should be performed in selected very elderly patients.

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Youn Yi Jo, Chun Gon Park, Ji Yeon Lee, Sun Koo Kwon, Hyun Jeong Kwak
Korean Journal of Anesthesiology.2019; 72(6): 599. 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
The Outcome and Propriety of Surgical Treatment of Colorectal Cancer in the Elderly
Hye-Won Hwang, Min-Young Koo, Jeong-Eun Lee, Ryung-Ah Lee, Kwang-Ho Kim
Journal of the Korean Surgical Society.2010; 78(2): 93. CrossRef

The Postoperative Impact of Co-morbidity in Colorectal Cancer Surgery.: Suh, Hee Seok , Lee, Kang Hong , Kim, Hee Cheol , Yu, Chang Sik , Kim, Jin Cheon; J Korean Soc Coloproctol. 2003;19(5):299-306.

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Abstract PDF: PURPOSE
Co-morbidity is the presence of co-existing or additional diseases during the initial diagnosis. It may be used as a prognostic indicator for the postoperative outcomes in most cancers, including colorectal cancers. The impact of respective co-morbidities in colorectal cancer surgeries were evaluated to identify their outcomes regarding complications and hospital stay.
METHODS
The medical records of 2,242 colorectal cancer patients, who had had curative operations between Jan. 1997 and Dec. 2001, were reviewed to evaluate the prevalence of co-morbidities. All co-morbidities were adequately evaluated and managed preoperatively.
RESULTS
Co-morbidities were observed in 789 out of the 2,242 (35.2%) patients. Hypertension was the most frequent (340, 15.2%), with diabetes (210, 9.4%) and cardiovascular diseases (124, 5.5%) following. Early stages (0~II) were more frequently associated with co-morbidities, compared to late stages (III~IV) (P<0.001). Hypertension and cerebrovascular diseases were significantly associated with postoperative complications (P<0.05). Postoperative complications occurred in 578 out of the 2242 (25.8%) patients: e.g., ileus (10.2%), voiding difficulty (4.4%), wound problems (4.3%), etc. Pulmonary complications occurred more often in patients with cerebrovascular diseases, hypertension, and asthma. Wound complications were observed in patients with hypertension, cerebrovascular diseases, chronic obstructive pulmonary disease, and chronic renal failure (P<0.05). Patients with more than one co-morbidity were closely associated with frequent postoperative co-mplications (P<0.05). However, comorbidities did not seem to affect the duration of the postoperative hospital stay.
CONCLUSIONS
Postoperative complications frequently occur in colorectal cancer patients with specific co- morbidities, especially in those with more than one. An adequate management of the co-morbidities preoperatively leads to a good outcome.

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