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. 2023 Oct-Dec;19(4):504-510.
doi: 10.4103/jmas.jmas_243_22.

Laparoscopic versus open surgical management in elderly patients with rectal cancer aged 70 and older

Xiaolong Li  1 , Hengwei Zhang  1 , Xudong Hou  1
Affiliations

Laparoscopic versus open surgical management in elderly patients with rectal cancer aged 70 and older

Xiaolong Li et al. J Minim Access Surg. 2023 Oct-Dec.

Abstract

Background: This retrospective study aimed to compare the short- and long-term surgical outcomes of laparoscopic surgery versus open surgery in elderly patients with rectal cancer.

Patients and methods: Elderly patients (≥70 years old) with rectal cancer who received radical surgery were retrospectively analysed. Patients were matched (1:1 ratio) using propensity score matching (PSM), with age, sex, body mass index, American Society of Anesthesiologists score and tumour-node-metastasis staging included as covariates. Baseline characteristics, post-operative complications, short- and long-term surgical outcomes and overall survival (OS) were compared between the two matched groups.

Results: Sixty-one pairs were selected after PSM. Patients with laparoscopic surgery had a longer duration of operation time, lower estimated blood loss, shorter duration of post-operative analgesics administered, time to first flatus, time to first oral diet and post-operative hospitalisation stay than those observed in patients with open surgery (All P < 0.05). The incidence of post-operative complications in the open surgery group was numerically higher than that occurred in the laparoscopic surgery group (30.6% vs. 17.7%). Median OS was 67.0 months (95% confidence interval [CI], 62.2-71.8) in the laparoscopic surgery group and 65.0 months (95% CI, 59.9-70.1) in the open surgery group, however, Kaplan-Meier curves indicated that no significant differences in OS (Log-rank test, P = 0.535) were noted between the two matched groups.

Conclusions: Compared with the open surgery, laparoscopic surgery had the advantages of less trauma and faster recovery, and provided similar long-term prognostic outcome in elderly patients with rectal cancer.

Keywords: Elderly patients; laparoscopic surgery; open surgery; rectal cancer; surgical outcomes.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Kaplan–Meier curves for OS in the two matched groups. OS: Overall survival
See this image and copyright information in PMC

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