Colorectal cancer surgery in octogenarians
Barış Gülcü , Tuncay Yılmazlar , Özgen Işık , Ersin Öztürk
Department of General Surgery, Uludag University School of Medicine, Bursa, Turkey
Objectives: The incidence of colorectal cancer becomes higher among octogenarians as the life expectancy increases. Whether advanced age is a risk factor for colorectal surgery is a matter of debate. In the present study, the clinical results of octogenarians who underwent colorectal cancer surgery are discussed to find an answer to this question.
Material and Methods: Data of 63 octogenarians who were operated in a tertiary colorectal surgery department between January 1, 2010 and December 31, 2013 were reviewed retrospectively. Demographic data and preoperative, peroperative, and postoperative parameters were evaluated.
Results: Overall, 57.2% of the patients were men. The median age was 81 (80–89) years. Cancer was located at the right colon in 17.5%, left colon in 50.8%, and rectum in 31.7%. Eleven patients underwent emergency surgery (17.5%). The most common surgical procedure was low anterior resection in elective (22.2%) and Hartmann’s procedure in the emergency setting (9.5%). Stoma creation was more frequent among patients undergoing emergency procedures (42% vs. 6.8%; p=0.0018). Histopathological diagnosis was adenocarcinoma in 90.5% of the patients, and 34.9% of the patients had stage IIIB disease. Surgical morbidity was significantly higher among patients who underwent rectal resection (66% vs. 10.2%; p=0.0124). Medical morbidity was observed in 10 (15.9%) patients. Preoperative blood transfusion was a risk factor for morbidity (83.4% vs. 29.8%; p=0.0170). Length of total hospital stay was 14 (3–39) days. Surgical (p=0.0004) and medical (p=0.0288) morbidity prolonged the length of total hospital stay. The overall mortality rate was 1.6%.
Conclusion: Colorectal surgery may be safely performed in octogenarians with acceptable morbidity and mortality in specialized centers.
Keywords: Colorectal, morbidity, mortality, octogenarian, surgery
This study was presented at the 15th National Colon and Rectal Surgery Congress, May 19-23, 2015, Antalya, Turkey.
Cite this paper as: Gülcü B, Yılmazlar T, Işık Ö, Öztürk E. Colorectal cancer surgery in octogenarians. Turk J Surg 2018; 34(4): 271-275
Ethics committee approval was received for this study from the Ethics Committee of Uludag University School of Medicine.
Informed consent was not received due to the retrospective nature of the study.
Concept - B.G., T.Y.; Design - B.G., T.Y.; Supervision - E.Ö., T.Y.; Resource - B.G., Ö.I.; Materials - B.G., Ö.I., E.Ö.; Data Collection and/or Processing - B.G., Ö.I.; Analysis and/or Interpretation - B.G., Ö.I., E.Ö.; Literature Search - B.G., Ö.I.; Writing Manuscript - B.G., Ö.I., T.Y.; Critical Reviews - E.Ö., T.Y.
The authors have no conflicts of interest to declare.
The authors declared that this study has received no financial support.