| 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 |
Related Documents
:
|
17275077 - Laparoscopy versus laparotomy for the surgical management of apparent early stage ovari... 16938157 - Parecoxib vs. lornoxicam in the treatment of postoperative pain after laparoscopic chol... 21088387 - Effect of weight loss maintenance on arterial compliance and metabolic and inflammatory... 456217 - Relationship of hiatal hernia to endoscopically proved reflux esophagitis. 21062397 - Application of resonance metallic stents for ureteral obstruction. 11684377 - Chlormadinone acetate versus micronized progesterone in the sequential combined hormone... |
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. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| 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
Previous Document: Protective effect of carbon dioxide against bacterial peritonitis induced in rats.
Next Document: Survival study of natural orifice translumenal endoscopic surgery for rectosigmoid resection using t...