Surgery for Elder Patients with Colorectal Cancer and Risk Factors for Postoperative Complication
American Journal of Clinical and Experimental Medicine
Volume 6, Issue 4, July 2018, Pages: 103-106
Received: Oct. 17, 2018;
Published: Oct. 18, 2018
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Zexian Chen, Department of Colorectal Surgery, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
Zheyu Zheng, Department of Colorectal Surgery, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
Xiaowen He, Department of Colorectal Surgery, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
Xiaosheng He, Department of Colorectal Surgery, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
Ping Lan, Department of Colorectal Surgery, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
With the increase in life expectancy and medical advance, surgical intervention for elderly patients with colorectal cancer is more and more frequent. In this retrospective study, this study mainly focused on surgery for elderly patients with colorectal cancer. In this study, the characteristics of preoperative, surgical and postoperative variables were described and risk factors for postoperative complication were analyzed. Totally, 221 patients were included in this study. The average age of patients was 78.84 years old and the preoperative nutritional status was roughly normal. 125 (56.56%) patients had comorbid diseases and 146 (67.59%) patients had an ASA score of 3 or 4. Emergency surgery was performed in 12 (5.43%) patients. 125 patients received open surgery while 96 received laparoscopic surgery among which 7 (7.29%) converted to open surgery. 36 (16.29%) patients had to get enterostomy. The average operative time was 220.00 min and the median blood loss was 100 ml with 55 (24.89%) patients needing intraoperative transfusion. As for risk factors for postoperative complication, patients with preoperative comorbid disease, longer operative time, more blood loss and intraoperative transfusion seemed more likely to have complication, although without significant difference. Preoperative low level of album (< 30 g/L) and emergency surgery were independent risk factors for postoperative complication (p = 0.037 and 0.021, respectively). In conclusion, surgery for elder patients with colorectal cancer had its own characteristics, and was controllable in general. Preoperative low level of album (< 30 g/L) and emergency surgery were independent risk factors for postoperative complication.
Surgery for Elder Patients with Colorectal Cancer and Risk Factors for Postoperative Complication, American Journal of Clinical and Experimental Medicine.
Vol. 6, No. 4,
2018, pp. 103-106.
Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet, 2016, 388(10053): 1459-1544.
Murray C J, Barber R M, Foreman K J, Abbasoglu O A, Abd-Allah F, Abera S F, et al. Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990-2013: quantifying the epidemiological transition. Lancet, 2015, 386(10009): 2145-2191.
U.S. Bureau of the Census (2008) Annual estimates of the resident population by sex and five-year age groups for the United States. Retrieved 21 July 2009 at http://www.census.gov/popest/national/asrh/NC-EST2008/NC-EST2008-01.xls. Vintage 2008.
Yang G, Wang Y, Zeng Y, Gao G F, Liang X, Zhou M, et al. Rapid health transition in China, 1990-2010: findings from the Global Burden of Disease Study 2010. Lancet, 2013, 381(9882): 1987-2015.
The proportion of population over 65 years old in China. http://www.kuaiyilicai.com/stats/global/yearly_per_country/g_population_65above_perc/chn-ind.html.
Bosetti C, Bertuccio P, Malvezzi M, Levi F, Chatenoud L, Negri E, et al. Cancer mortality in Europe, 2005-2009, and an overview of trends since 1980. Ann Oncol, 2013, 24(10): 2657-2671.
Levi F, Lucchini F, Negri E, Boyle P, La Vecchia C. Changed trends of cancer mortality in the elderly. Ann Oncol, 2001, 12(10): 1467-1477.
Folprecht G, Cunningham D, Ross P, Glimelius B, Di Costanzo F, Wils J, et al. Efficacy of 5-fluorouracil-based chemotherapy in elderly patients with metastatic colorectal cancer: a pooled analysis of clinical trials. Ann Oncol, 2004, 15(9): 1330-1338.
Tan K Y, Konishi F, Kawamura Y J, Maeda T, Sasaki J, Tsujinaka S, et al. Laparoscopic colorectal surgery in elderly patients: a case-control study of 15 years of experience. Am J Surg, 2011, 201(4): 531-536.
Martinek L, Dostalik J, Gunka I, Gunkova P, Zonca P. Is age a risk factor for laparoscopic colorectal surgery? Zentralbl Chir, 2011, 136(3): 264-268.
Gunka I, Dostalik J, Martinek L, Gunkova P, Mazur M, Vavra P. Advanced age--indication or contraindication for laparoscopic colorectal surgery? Rozhl Chir, 2010, 89(10): 628-633.
Whittle J, Steinberg E P, Anderson G F, Herbert R. Results of colectomy in elderly patients with colon cancer, based on Medicare claims data. Am J Surg, 1992, 163(6): 572-576.
Longo W E, Virgo K S, Johnson F E, Oprian C A, Vernava A M, Wade T P, et al. Risk factors for morbidity and mortality after colectomy for colon cancer. Dis Colon Rectum, 2000, 43(1): 83-91.
Tabola R, Mantese G, Cirocchi R, Gemini A, Grassi V, Boselli C, et al. Postoperative mortality and morbidity in older patients undergoing emergency right hemicolectomy for colon cancer. Aging Clin Exp Res, 2017, 29(Suppl 1): 121-126.
Pinto R A, Ruiz D, Edden Y, Weiss E G, Nogueras J J, Wexner S D. How reliable is laparoscopic colorectal surgery compared with laparotomy for octogenarians? Surg Endosc, 2011, 25(8): 2692-2698.
Ma L, Wang L, Ding K, Liu G, Zhang D. Effect of fast tract surgery on immune and inflammatory reaction of elder patients with colorectal cancer. Zhonghua Wei Chang Wai Ke Za Zhi, 2014, 17(12): 1223-1226.