ABSTRACT
BACKGROUND: The aim of this study was to investigate the short- and long-term outcomes after elective laparoscopic surgery (LPS) for colorectal cancer patients over 80 years of age. METHODS: This was a retrospective study of all patients of 80 and above, who underwent elective colorectal resection, between January 2007 and January 2016. Data were analysed from a prospectively collected cancer database and cross checked with patient records. Determinants of survival were analysed using log-rank test and Kaplan-Meier curves. RESULTS: We identified 293 patients; 110 underwent LPS. LPS had significantly better overall survival (p = 0.0065) and disease-free survival (DFS) (p = 0.006). The LPS group also had a shorter length of stay (LOS)-9 vs 11 days (p < 0.00001), 90-day mortality-5.5 vs 13.7% (p = 0.03) and required fewer blood transfusions 22.7 vs 40.4% (p = 0.002), when compared to open surgery (OPS). There was no difference in 30-day mortality 1.8 vs 4.9% (p = 0.22), anastomotic leakage 2.3 vs 6% (p = 0.20) or post-operative complication rates 44.5 vs 50.8% (p = 0.30). CONCLUSIONS: LPS for patients in their 80s is characterised by better overall and DFS compared to open procedures and is associated with shorter post-operative LOS, and significantly lower 90-day mortality. Patients operated on laparoscopically also required fewer post-operative blood transfusions.
Subject(s)
Colorectal Neoplasms , Elective Surgical Procedures , Laparoscopy , Long Term Adverse Effects , Postoperative Complications , Aged, 80 and over , Colorectal Neoplasms/mortality , Colorectal Neoplasms/pathology , Colorectal Neoplasms/surgery , Disease-Free Survival , Elective Surgical Procedures/adverse effects , Elective Surgical Procedures/methods , Female , Humans , Laparoscopy/adverse effects , Laparoscopy/methods , Laparoscopy/statistics & numerical data , Long Term Adverse Effects/epidemiology , Long Term Adverse Effects/etiology , Male , Postoperative Complications/diagnosis , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Retrospective Studies , Survival Analysis , Treatment OutcomeABSTRACT
We present the case of an 80-year-old retired consultant histopathologist who presented to us with a malignant umbilical mass 8years following resection of a sigmoid adenoma. The report details initial investigation and management of the umbilical mass and the subsequently discovered pelvic recurrence. Our conclusions of its origin, as a malignant transformation due to seeding of the original sigmoid adenoma, show the slow progression of some colorectal tumours; and the importance of obtaining a complete specimen intra-operatively.
