Impact of the laparoscopic approach, early closure and preoperative stimulation on outcomes of ileostomy closure after rectal resection.

AIM: To evaluate the clinical outcome of early closure of a protective ileostomy and preoperative stimulation of the efferent limb in a cohort of patients with rectal cancer treated surgically, primarily using the laparoscopic approach. METHODS: We performed an observational retrospective cohort study in a prospectively recorded series of patients with rectal cancer who underwent laparoscopic surgery with a protective loop ileostomy between 2017 and 2022. Ileostomy closure was programmed for within 3 months after surgery. All patients underwent stimulation of the efferent limb. Primary outcomes were morbidity and mortality, length of stay (LOS), and re-admission. RESULTS: Between 2017 and 2022, 108 patients underwent resection for rectal cancer and protective ileostomy. The laparoscopic approach was performed in 84.3% of patients (n = 91). Permanent ileostomy was performed in 5 patients (4.6%). Ileostomy closure was thus performed in 95.4% of patients (n = 103). Median time to closure was 74.5 days (range 57-113). In 63.1% (n = 65) of patients, reconstructive surgery was performed within 90 days. Prior to closure, efferent limb stimulation was performed in 77.8% (n = 84) of patients. Global morbidity was 26.2% (n = 27) (85.19%, n = 23 Clavien-Dindo I and 7.41%, n = 2 Clavien-Dindo II). The main causes of morbidity were postoperative ileus (10.7%, n = 11) and rectal bleeding (8.7%, n = 9). Anastomosis leakage occurred in 2 patients. Median hospital stay was 6 days (5-7). Readmission was needed in 6.8% (n = 7) of patients. CONCLUSION: A previous laparoscopic approach, early closure and stimulation of the efferent limb could be a useful strategy to reduce the morbidity and mortality of temporary ileostomy closure.

Reacreditación o recertificación de los cirujanos generales en España: esa es la cuestión. Resultados de una encuesta nacional / Reaccreditation or recertification of general surgeons in Spain: That's the question. Results of a national survey

Introducción: La Ley de Ordenación de las Profesiones Sanitarias (LOPS) indica que los profesionales sanitarios realizarán a lo largo de su vida profesional una formación continuada y acreditarán regularmente su competencia profesional. El objetivo del estudio ha sido realizar una encuesta nacional para conocer la opinión de los cirujanos españoles y así poder preparar un proyecto de recertificación por la Asociación Española de Cirujanos (AEC).Métodos: Estudio observacional transversal efectuado en junio-julio de 2020 mediante una encuesta remitida a los miembros de la AEC. Resultados: La encuesta tuvo un total de 1.230 visitas y una tasa global de finalización de 784 respuestas (67,3%). El 69,6% desconocían las previsiones de la LOPS, el 83,4% no conocían iniciativas similares en otras especialidades y el 95,5% coincidían en demandar una información adecuada. El 71,4% la creían necesaria, pero solo el 57% opinaban que debería ser obligatoria. El 82,9% estarían de acuerdo que debería ser regulada mediante un procedimiento oficial objetivo y previsible. Conclusiones: El concepto de reacreditación no es bien conocido en nuestra especialidad, y en vista de los resultados obtenidos parece necesaria una información adecuada y fiable. Por ello sería pertinente proponer por la AEC un proyecto específico de evaluación de actividades y competencias(AU)

Introduction: The Law for the Regulation of Health Professions (LOPS) indicates that health professionals will carry out continuous training throughout their professional life, and will regularly prove their professional competence. The objective of the study was to carry out a national survey to find out the opinion of Spanish surgeons and thus be able to prepare a recertification project by the Spanish Association of Surgeons (AEC). Methods: Cross-sectional observational study carried out in June-July 2020, through a survey sent to the members of the AEC. Results: The survey had a total of 1230 visits and an overall completion rate of 784 responses (67.3%). 69.6% were unaware of the LOPS forecasts and 83.4% were unaware of similar initiatives in other specialties and 95.5% agreed to demand adequate information. 71.4% believed it necessary but only 57% believed that it should be mandatory. 82.9% would agree that it should be regulated through an objective and predictable official procedure. Conclusions: he concept of re-accreditation is not well known in our specialty and in view of the results obtained, adequate and reliable information seems necessary. Therefore, it would be pertinent to propose by the AEC a specific project to assess activities and skills(AU)

Reaccreditation or recertification of general surgeons in Spain: That's the question. Results of a national survey.

INTRODUCTION: The Law for the Regulation of Health Professions (LOPS) indicates that health professionals will carry out continuous training throughout their professional life, and will regularly prove their professional competence. The objective of the study was to carry out a national survey to find out the opinion of Spanish surgeons and thus be able to prepare a recertification project by the Spanish Association of Surgeons. METHODS: Cross-sectional observational study carried out in June-July 2020, through a survey sent to the members of the Spanish Association of Surgeons. RESULTS: The survey had a total of 1230 visits and an overall completion rate of 784 responses (67.3%). 69.6% were unaware of the LOPS forecasts and 83.4% were unaware of similar initiatives in other specialties and 95.5% agreed to demand adequate information. 71.4% believed it necessary but only 57% believed that it should be mandatory. 82.9% would agree that it should be regulated through an objective and predictable official procedure. CONCLUSIONS: The concept of re-accreditation is not well known in our specialty and in view of the results obtained, adequate and reliable information seems necessary. Therefore, it would be pertinent to propose by the A.E.C. a specific project to assess activities and skills.

Reaccreditation or recertification of general surgeons in Spain: That's the question. Results of a national survey. / Reacreditación o recertificación de los cirujanos generales en España: esa es la cuestión. Resultados de una encuesta nacional.

INTRODUCTION: The Law for the Regulation of Health Professions (LOPS) indicates that health professionals will carry out continuous training throughout their professional life, and will regularly prove their professional competence. The objective of the study was to carry out a national survey to find out the opinion of Spanish surgeons and thus be able to prepare a recertification project by the Spanish Association of Surgeons (AEC). METHODS: Cross-sectional observational study carried out in June-July 2020, through a survey sent to the members of the AEC. RESULTS: The survey had a total of 1230 visits and an overall completion rate of 784 responses (67.3%). 69.6% were unaware of the LOPS forecasts and 83.4% were unaware of similar initiatives in other specialties and 95.5% agreed to demand adequate information. 71.4% believed it necessary but only 57% believed that it should be mandatory. 82.9% would agree that it should be regulated through an objective and predictable official procedure. CONCLUSIONS: The concept of re-accreditation is not well known in our specialty and in view of the results obtained, adequate and reliable information seems necessary. Therefore, it would be pertinent to propose by the AEC a specific project to assess activities and skills.

Hernia diafragmática postraumática / Post-traumatic diaphragmatic hernia

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Fístula colovesical: aplicabilidad del abordaje laparoscópico y resultados según su etiología / Colovesical Fistula: Applicability of the Laparoscopic Approach and Results According to Etiology

INTRODUCCIÓN: Las fístulas colovesicales son una entidad poco frecuente y con una incidencia precisa desconocida. El objetivo de este estudio es describir una serie de casos de pacientes intervenidos por fístula colovesical de origen benigno y maligno y valorar la aplicabilidad del abordaje laparoscópico en ambos grupos. MÉTODOS: Realizamos un estudio descriptivo de 34 pacientes intervenidos en nuestro centro entre enero de 2001 y marzo de 2018 con el diagnóstico de fístula colovesical. Se incluyen pacientes intervenidos de manera electiva (28) y de urgencia (6). Se categorizaron según el diagnóstico mediante pruebas complementarias por TC abdominal, colonoscopia y cistoscopia, y se realizó un abordaje laparoscópico en los pacientes sin infiltración del trígono vesical y plano retroperitoneal y con situación clínica favorable. RESULTADOS: En los casos con patología benigna (13) se realizaron 4 intervenciones vía laparotómica y 9 vía laparoscópica, con 3 conversiones. En todos los casos se realizó sigmoidectomía. En 11 pacientes se realizó cistectomía parcial y en 2 casos el manejo fue conservador con sonda vesical. En los 21 pacientes con patología maligna se realizaron 5 abordajes laparoscópicos y se convirtieron 3, con 16 casos abordados vía laparotómica. Se realizaron sigmoidectomía, hemicolectomía izquierda, resección anterior y exenteración pélvica, y abordaje urológico en todos los casos. Dieciséis pacientes (76%) tuvieron complicaciones, la mayoría menores (I-II según la clasificación de Clavien-Dindo) e intervenidos por abordaje laparotómico. CONCLUSIONES: El tratamiento de elección en las fístulas colovesicales es la cirugía con resección colónica y abordaje urológico según el caso y el diagnóstico etiológico. El abordaje laparoscópico puede ser factible en casos muy bien seleccionados y con una situación clínica favorable, teniendo en cuenta que el umbral de conversión debe ser bajo y la intervención ha de ser llevada a cabo por un equipo con experiencia

INTRODUCTION: Colovesical fistulae have significant morbidity. The aim of our study was to describe a case series of benign and malignant colovesical fistulae, focusing on the viability of the laparoscopic approach. METHODS: We reviewed the characteristics of 34 patients with diverticular and colon adenocarcinoma-related colovesical fistulae treated surgically from January 2001 to March 2018, 28 with elective surgery and 6 by urgent surgery. The diagnosis was established by abdominal CT scan, colonoscopy and cystoscopy. Clinically stable patients, with no retroperitoneal or bladder trigone invasion, were approached laparoscopically. RESULTS: There were 13 benign cases (all of them approached by sigmoidectomy), 9 performed by laparoscopy with 3 conversions. Partial cystectomy was done in 11 cases, and in two cases conservative management with urinary catheter. Five laparoscopic approaches were performed in 21 patients diagnosed with malignant colovesical fistula, with 3 conversions and 16 laparotomies. The procedures were sigmoidectomy, left colectomy, anterior resection and pelvic exenteration. All of them required partial or total cystectomy. Sixteen patients had complications, most of which were minor (Clavien-Dindo classificationI-II) and with laparotomy approach. CONCLUSIONS: The laparoscopic approach can be feasible in well-selected and stable patients, but we have to take into consideration that the conversion rate can be high and this surgery should be performed by experienced surgeons

Colovesical Fistula: Applicability of the Laparoscopic Approach and Results According to Etiology. / Fístula colovesical: aplicabilidad del abordaje laparoscópico y resultados según su etiología.

INTRODUCTION: Colovesical fistulae have significant morbidity. The aim of our study was to describe a case series of benign and malignant colovesical fistulae, focusing on the viability of the laparoscopic approach. METHODS: We reviewed the characteristics of 34 patients with diverticular and colon adenocarcinoma-related colovesical fistulae treated surgically from January 2001 to March 2018, 28 with elective surgery and 6 by urgent surgery. The diagnosis was established by abdominal CT scan, colonoscopy and cystoscopy. Clinically stable patients, with no retroperitoneal or bladder trigone invasion, were approached laparoscopically. RESULTS: There were 13 benign cases (all of them approached by sigmoidectomy), 9 performed by laparoscopy with 3 conversions. Partial cystectomy was done in 11 cases, and in two cases conservative management with urinary catheter. Five laparoscopic approaches were performed in 21 patients diagnosed with malignant colovesical fistula, with 3 conversions and 16 laparotomies. The procedures were sigmoidectomy, left colectomy, anterior resection and pelvic exenteration. All of them required partial or total cystectomy. Sixteen patients had complications, most of which were minor (Clavien-Dindo classificationI-II) and with laparotomy approach. CONCLUSIONS: The laparoscopic approach can be feasible in well-selected and stable patients, but we have to take into consideration that the conversion rate can be high and this surgery should be performed by experienced surgeons.

Uso de las redes sociales por parte de los cirujanos generales. Resultados de la encuesta nacional de la Asociación Española de Cirujanos / Use of social networks by general surgeons. Results of the national survey of the Spanish Association of Surgeons

Introducción: Se desconoce el uso y utilidad de las redes sociales (RR.SS.) entre los cirujanos generales españoles. Métodos: Entre octubre y diciembre de 2017 se realizó una encuesta online a los socios de la Asociación Española de Cirujanos, en la que se recogieron datos de perfil de uso y de opinión sobre RR. SS. Resultados: Se obtuvo respuesta de 360 cirujanos, de los cuales 310 tenían presencia en RR.SS. Las redes más populares fueron: Facebook (86%), LinkedIn (61.6%), YouTube (60,6%) y Twitter (54,2%). LinkedIn y Twitter destacaron como las RR.SS. más empleadas con fines profesionales. Los cirujanos con presencia en RR.SS. eran más jóvenes (42,4 ± 11 años frente a 51,6 ± 8 años; p < 0,001), existiendo a menor edad mayor frecuencia de acceso a las mismas. El género no mostró influencia sobre la presencia en RR.SS. La mayoría de los encuestados tiene perfil en más de una red (3,6 ± 1 cuentas) y el 73,5% comunicó acceder a ellas diariamente. El 19,7% de los servicios de cirugía al que pertenecen los encuestados tiene perfil en RR. SS. Entre las utilidades profesionales destacan las actividades formativas (87%) y el contacto con otros profesionales (84%). El 14,1% de los encuestados utilizan RR. SS. para relacionarse con los pacientes. Conclusiones: Las RR.SS. son útiles para la divulgación de información sobre eventos científicos y actividades formativas, la actualización y adquisición de conocimientos y la comunicación entre profesionales. Aspectos como la privacidad o la relación con los pacientes representan una barrera en el uso de RR. SS

Introduction: The use and utility of social media (SM) among Spanish general surgeons is unknown. Methods: Between October and December 2017 an online survey was carried out to the members of the Spanish Association of Surgeons, in which data on the profile of use and opinion on the usefulness of SM were collected. Results: 360 valid responses were obtained, 310 from surgeons who had an active SM profile. The most popular networks were: Facebook (86%), LinkedIn (61,6%), YouTube (60,6%) and Twitter (54,2%). LinkedIn and Twitter stood out as the most used SM for professional purposes. Surgeons with a SM profile were younger (42.4 ± 11 years versus 51.6 ± 8 years; P < .001). Gender did not show influence on presence in SM. The majority of respondents have profiles in more than one network (3.6 ± 1 accounts) and 73.5% reported daily access to them; 19.7% of the surgery departments to which the respondents belong have a SM account. Among SM utilities in the professional field, training activities (87%) and connectivity among professionals (84%) were the most outstanding; 14.1% of respondents use SM to interact with patients. Conclusions: SM is useful as a tool for the acquisition, updating and dissemination of scientific knowledge, also proving valuable as a new form of interaction among surgeons. Other issues such as privacy or surgeon-patient relationship represent a barrier to its use

Use of social networks by general surgeons. Results of the national survey of the Spanish Association of Surgeons. / Uso de las redes sociales por parte de los cirujanos generales. Resultados de la encuesta nacional de la Asociación Española de Cirujanos.

INTRODUCTION: The use and utility of social media (SM) among Spanish general surgeons is unknown. METHODS: Between October and December 2017 an online survey was carried out to the members of the Spanish Association of Surgeons, in which data on the profile of use and opinion on the usefulness of SM were collected. RESULTS: 360 valid responses were obtained, 310 from surgeons who had an active SM profile. The most popular networks were: Facebook (86%), LinkedIn (61,6%), YouTube (60,6%) and Twitter (54,2%). LinkedIn and Twitter stood out as the most used SM for professional purposes. Surgeons with a SM profile were younger (42.4±11 years versus 51.6±8 years; P<.001). Gender did not show influence on presence in SM. The majority of respondents have profiles in more than one network (3.6±1 accounts) and 73.5% reported daily access to them; 19.7% of the surgery departments to which the respondents belong have a SM account. Among SM utilities in the professional field, training activities (87%) and connectivity among professionals (84%) were the most outstanding; 14.1% of respondents use SM to interact with patients. CONCLUSIONS: SM is useful as a tool for the acquisition, updating and dissemination of scientific knowledge, also proving valuable as a new form of interaction among surgeons. Other issues such as privacy or surgeon-patient relationship represent a barrier to its use.

Tratamiento mediante microcirugía endoscópica transanal de un hamartoma quístico retrorrectal birrecidivado / Transanal endoscopic microsurgery treatment of twice recurred tail-gut

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Reparación laparoscópica de una hernia de Morgagni y hemicolectomía derecha ampliada por neoplasia de colon / Laparoscopic assisted repair of Morgagni hernia and extended right colectomy for colon cancer

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Are there differences between right and left colectomies when performed by laparoscopy?

BACKGROUND: There is an extended belief that the laparoscopic approach to left colectomy (LC) is technically more demanding and associated with more postoperative complications than to right colectomy (RC). However, there is no consensus in the literature about whether the short-term outcomes of RC differ from those of LC. The aim of this paper was to compare the postoperative course of patients undergoing RC and LC. METHODS: We retrospectively analyzed 1000 consecutive patients who underwent a laparoscopic RC or LC between 1998 and 2012. Factors analyzed were intraoperative complications, surgical time, postoperative complications, and length of stay. The two groups were divided into four subgroups (neoplasia, diverticular disease, polyps, and others). RESULTS: LC was associated with more postoperative complications than RC and longer operative time both in the two main groups (postoperative complications 30 vs. 19%; operative time 139 vs. 118 min) and in the neoplasia subgroups (27 vs. 18%; 137 vs. 118 min). No differences between groups were found for rates of reintervention or death. Comparison between LC subgroups showed that the operative time was longer and the conversion rate was higher in the diverticular disease subgroup than in the neoplasia subgroup (155 vs. 137 min; 21 vs. 8%). CONCLUSIONS: In this large cohort of patients undergoing laparoscopic colectomy, LC carried a higher risk than RC of postoperative complications. These findings provide new data on the differences between the two surgeries. Our findings strengthen the notion that right and left colectomies have a different intraoperative and postoperative course and should be analyzed as two separate entities.

25 años de cirugía laparoscópica en España / 25 years of laparoscopic surgery in Spain

INTRODUCCIÓN: La introducción de la cirugía laparoscópica (CL) puede considerarse el avance más importante que ha experimentado nuestra especialidad en los últimos 25 años. A pesar de sus ventajas, la implantación y consolidación de la CL no ha sido homogénea, especialmente si tenemos en cuenta las técnicas laparoscópicas avanzadas. El objetivo de este trabajo es analizar el nivel de desarrollo e implantación de la CL en España en el momento actual y analizar su evolución en los últimos años. MATERIAL Y MÉTODOS: Durante el segundo semestre de 2012 se desarrolló una encuesta que evaluaba distintos aspectos relacionados con la implantación y el desarrollo de la CL en nuestro país. La encuesta se realizó mediante un cuestionario electrónico. RESULTADOS: La tasa global de respuesta a la encuesta fue del 16% y 103 jefes de Servicio contestaron el cuestionario. El 92% correspondió a cirujanos de centros sanitarios públicos. El 99% de los encuestados realizaba CL básica y el 85,2%, avanzada. La mayor parte de los encuestados (79%) considera que el instrumental y los equipos para CL de los que dispone son correctos y el 71% considera que, en su medio, la CL está en el lugar adecuado. CONCLUSIONES: La CL básica ha logrado desarrollarse en nuestro país hasta considerarse un estándar practicado por la mayoría de los cirujanos y ser parte de la formación básica del residente de cirugía. Con respecto a la CL avanzada, aunque los porcentajes de utilización son altos, todavía existen déficits y, en consecuencia, oportunidades de mejora

INTRODUCTION: The introduction of laparoscopic surgery (LS) can be considered the most important advancement in our specialty in the past 25 years. Despite its advantages, implementation and consolidation has not been homogenous, especially for advanced techniques. The aim of this study was to analyse the level of development and use of laparoscopic surgery in Spain at the present time and its evolution in recent years. MATERIAL AND METHODS: During the second half of 2012 a survey was developed to evaluate different aspects of the implementation and development of LS in our country. The survey was performed using an electronic questionnaire. RESULTS: The global response rate was 16% and 103 heads of Department answered the survey. A total of 92% worked in the public system. A total of 99% perform basic laparoscopic surgery and 85,2% advanced LS. Most of the responders (79%) consider that the instruments they have available for LS are adequate and 71% consider that LS is in the right stage of development in their environment. CONCLUSIONS: Basic laparoscopic surgery has developed in our country to be considered the standard performed by most surgeons, and forms part of the basic surgical training of residents. With regards to advanced LS, although it is frequently used, there are still remaining areas of deficit, and therefore, opportunities for improvement

[25 years of laparoscopic surgery in Spain]. / 25 años de cirugía laparoscópica en España.

INTRODUCTION: The introduction of laparoscopic surgery (LS) can be considered the most important advancement in our specialty in the past 25 years. Despite its advantages, implementation and consolidation has not been homogenous, especially for advanced techniques. The aim of this study was to analyse the level of development and use of laparoscopic surgery in Spain at the present time and its evolution in recent years. MATERIAL AND METHODS: During the second half of 2012 a survey was developed to evaluate different aspects of the implementation and development of LS in our country. The survey was performed using an electronic questionnaire. RESULTS: The global response rate was 16% and 103 heads of Department answered the survey. A total of 92% worked in the public system. A total of 99% perform basic laparoscopic surgery and 85,2% advanced LS. Most of the responders (79%) consider that the instruments they have available for LS are adequate and 71% consider that LS is in the right stage of development in their environment. CONCLUSIONS: Basic laparoscopic surgery has developed in our country to be considered the standard performed by most surgeons, and forms part of the basic surgical training of residents. With regards to advanced LS, although it is frequently used, there are still remaining areas of deficit, and therefore, opportunities for improvement.

Factores de morbimortalidad postoperatoria tras cirugía laparoscópica por cáncer de colon en pacientes octogenarios / Postoperative morbidity and mortality factors after laparoscopic resection for colon cancer in octogenarians

Introducción: Dado el aumento del diagnóstico de cáncer de colon y el acceso al tratamiento en pacientes mayores de 80 años, nuestro objetivo es valorar si el abordaje laparoscópico sigue aportando las ventajas demostradas en la recuperación postoperatoria, al tiempo que analizamos los factores que pueden influir en dichos resultados. Material y método Se han analizado retrospectivamente 593 pacientes, intervenidos de cáncer de colon por laparoscopia de forma electiva entre enero de 1999 y diciembre de 2010. Se dividieron en 33 grupos: A) menores de 70 años (n = 230), B) 70-79 años (n = 209), C) mayores o igual a 80 años (n=154). Las variables independientes: sexo, enfermedades asociadas, cirugía abdominal previa, índice de Karnosfky, índice de masa corporal (IMC), nivel de hemoglobina, proteínas y albúmina, CEA, grado de ASA, localización y estadificación tumoral. Variables dependientes perioperatoria: conversión, tiempo operatorio y pérdidas hemáticas; y postoperatorias: complicaciones locales y generales, requerimiento de unidad de cuidados intensivos, reintervenciones, estancia hospitalaria y éxitus. Resultados El grupo C presentó una mayor incidencia (p<0,001) de hipertensión arterial, diabetes mellitus, cardiopatía, neumopatía y ASA grado 3, así como valores inferiores de índice de Karnofsky, IMC, hemoglobina, albúmina y proteínas totales. Durante el postoperatorio se observó (p>0,001), mayor incidencia de complicaciones generales (respiratorias y urinarias), reintervenciones, ingresos en unidad de cuidados intensivos, éxitus y mayor estancia hospitalaria. Conclusión Aunque la cirugía laparoscópica ofrece ventajas a los pacientes mayores de 80 años con cáncer de colon, este grupo de pacientes presenta un mayor riesgo de complicaciones que la población más joven y, en consecuencia, debemos ser cuidadosos en su manejo (AU)

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 (..) (AU)

[Postoperative morbidity and mortality factors after laparoscopic resection for colon cancer in octogenarians]. / Factores de morbimortalidad postoperatoria tras cirugía laparoscópica por cáncer de colon en pacientes octogenarios.

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 post-operative: 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.