Colorectal cancer treatment in octogenarians: elective or emergency surgery?

BACKGROUND: The purpose of this research was to assess the characteristics of octogenarian patients with colorectal cancer and compare specific outcomes due to different types of surgical procedures used to treat the disease. METHODS: A total of 346 octogenarian patients undergoing surgery for colorectal cancer between April 2000 and April 2010 were retrospectively assessed according to elective (n = 261) or emergent (n = 85) admission group. The two groups were compared for clinical variables, surgical procedures, morbidity and mortality, ICU admission, length of hospital stay and overall survival. RESULTS: The two groups had similar comorbidities. The emergent group had a more advanced Dukes' stage, higher American Society of Anesthesiologists grading, lower anastomosis rate (40.2 vs 80.1%), higher stoma rate (30.6 vs 9.6%), more complications (71.8 vs 43.3%), nine days longer length of hospital stay and higher (82.4% vs 36.4%) ICU admission rate. Overall mortality was 9.5%, with a higher mortality rate in the emergent group (30.6%) than the elective group (3.1%). CONCLUSIONS: Octogenarians who undergo elective colorectal cancer surgery have better results than those requiring emergent surgery, but both are quite acceptable and we recommend surgical intervention should not be delayed.

Minimally invasive video-assisted thyroidectomy for accidental papillary thyroid microcarcinoma: comparison with conventional open thyroidectomy with 5 years follow-up / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Minimally invasive video-assisted thyroidectomy (MIVAT) has received increasing attention for malignant thyroid diseases. The aim of this study was to compare the outcomes of MIVAT with conventional open thyroidectomy (CT) for papillary thyroid microcarcinoma (PTMC).</p><p><b>METHODS</b>Thirty-one patients were treated with MIVAT and 37 with CT. Their pathological characteristics, surgical complications, 5-year postoperative thyroglobulin (TG) and ultrasonic results were followed up.</p><p><b>RESULTS</b>All the patients took levothyroxine for suppressing thyroid stimulating hormone (TSH) after surgery, and were followed up with measurement of serum TG and neck ultrasonography at intervals of 6 or 12 months. There was no statistically significant difference between the CT and MIVAT groups for sex ratio, operation time, positive lymph nodes, complications and prognosis, but the MIVAT group had better cosmetic results.</p><p><b>CONCLUSIONS</b>MIVAT did not differ significantly from CT for PTMC after 5 years follow-up, but it did have better cosmetic results. MIVAT is a safe and valid surgical technique for selected cases.</p>