Postoperative morbidity and mortality factors after laparoscopic resection for colon cancer in octogenarians.
Por:
Lucas, MA, Ponz, CB, Segura, JLP, Puyal, AC, Casanovas, PH, Sanchez, MCM, Soler, ET, Folch, MT
Publicada:
1 nov 2012
Resumen:
Introduction: Given the increase in the diagnosis in colon cancer and the access to treatment in patients over 80 years old, our aim is to assess whether laparoscopic surgery still has the demonstrated advantages in post-operative recovery, as well as to analyse the factors that may influence these results.
Material and method: A retrospective analysis was made on a total of 593 patients subjected to elective laparoscopy surgery due to cancer of the colon between January 1999 and December 2010. They were divided into three age groups: A) less than 70 years (n = 230), B) 70-79 years (n = 209), C) 80 years or over (n = 154). The independent variables were: gender, concomitant diseases, previous abdominal surgery, Karnosfky index, BMI, level of, haemoglobin, proteins and albumin, CEA, and ASA grade, location and stage of tumour. The peri-operative dependent variables were: conversion, operating time and blood loss; and postoperative: local and general complications, need for intensive care, further surgery, hospital stay, and death.
Results: Group C had a higher incidence (P<.001) of arterial hypertension, diabetes mellitus, heart disease, chest disease and grade 3 ASA, as well as lower values for the Karnofsky Index, body mass index (BMI), haemoglobin, albumin and total protein. A higher incidence (P>.001) of general complications (respiratory and urinary), further surgery, admission to intensive care unit, longer hospital stay and death, was also observed in the post-operative period in this group.
Conclusion: Although laparoscopic surgery offers advantages to patients over 80 years-old, this group has a higher risk of complications than the younger population and, as a result, we must take great care in their management. (C) 2012 AEC. Published by Elsevier Espana, S.L. All rights reserved.
Filiaciones:
Lucas, MA:
Hosp Santa Creu & Sant Pau, Serv Cirugia & Gen Digest, Barcelona, Spain
Ponz, CB:
Hosp Santa Creu & Sant Pau, Serv Cirugia & Gen Digest, Barcelona, Spain
Segura, JLP:
Hosp Santa Creu & Sant Pau, Serv Cirugia & Gen Digest, Barcelona, Spain
Puyal, AC:
Hosp Santa Creu & Sant Pau, Serv Cirugia & Gen Digest, Barcelona, Spain
Casanovas, PH:
Hosp Santa Creu & Sant Pau, Serv Cirugia & Gen Digest, Barcelona, Spain
Sanchez, MCM:
Hosp Santa Creu & Sant Pau, Serv Cirugia & Gen Digest, Barcelona, Spain
Soler, ET:
Hosp Santa Creu & Sant Pau, Serv Cirugia & Gen Digest, Barcelona, Spain
Folch, MT:
Hosp Santa Creu & Sant Pau, Serv Cirugia & Gen Digest, Barcelona, Spain
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