Document Detail


Laparoscopic colectomy is safe and leads to a significantly shorter hospital stay for octogenarians.
MedLine Citation:
PMID:  20174947     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Concerns about prolonged postoperative recovery may detract surgeons from offering colectomy to patients older than 80 years. The adoption of a minimally invasive approach may help to counter these beliefs, but concerns remain as to whether these patients can tolerate a pneumoperitoneum. This study compared outcomes after laparoscopic colectomy (LC) and open colectomy (OC) for patients older than 80 years. METHODS: From a prospectively maintained database, 97 patients undergoing elective LC between 1994 and 2008 were identified and matched 1:1 to OC patients for age, gender, year of surgery, extent of resection, proximal diversion, American Society of Anesthesiology score, and body mass index. Short-term outcomes including postoperative mortality, morbidity, and discharge status were assessed. RESULTS: The LC and OC patients were similar for the matched characteristics. Their mean age was 82.8 years (range, 80-94 years). The conversion rate for the LC patients was 14.4%. The OC group had a higher proportion of cancer patients (93.8% vs. 59.8%; P = 0.001). The discharge status for the LC and OC patients was similar, and most patients were discharged home without assistance (63.9% vs. 62.9%; P = 0.88). The median hospital stay was significantly shorter for LC (6 days; range, 1-67 days) than for OC (7 days; range, 2-53 days; P = 0.001). The 30-day postoperative complications (OC, 43.3% vs. LC, 37.1%; P = 0.38), reoperations (OC, 5.2% vs. LC, 4.1%; P = 0.73), and readmissions (OC, 6.2% vs. LC, 9.3%; P = 0.41) were similar. The overall mortality rate was 5.2% and similar between the two groups. CONCLUSION: Complications and other outcomes are similar for LC and OC, and the earlier recovery associated with LC, as evidenced by a shorter hospital stay, may encourage a wider adoption of LC for patients older than 80 years.
Authors:
Lei Lian; Matthew Kalady; Daniel Geisler; Ravi Pokala Kiran
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-02-21
Journal Detail:
Title:  Surgical endoscopy     Volume:  24     ISSN:  1432-2218     ISO Abbreviation:  Surg Endosc     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-02     Completed Date:  2010-11-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8806653     Medline TA:  Surg Endosc     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  2039-43     Citation Subset:  IM    
Affiliation:
Department of Colorectal Surgery, Digestive Disease Center-A30, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged, 80 and over
Colectomy / methods*
Female
Humans
Laparoscopy*
Length of Stay / statistics & numerical data*
Male
Prospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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