Australasian Laparoscopic Colon Cancer Study shows that elderly patients may benefit from lower postoperative complication rates following laparoscopic versus open resection

Author:

Allardyce R A1,Bagshaw P F1,Frampton C M2,Frizelle F A1,Hewett P J34,Rieger N A34,Smith J S5,Solomon M J67,Stevenson A R L8

Affiliation:

1. Department of Surgery, University of Otago, Christchurch, New Zealand

2. Department of Medicine, University of Otago, Christchurch, New Zealand

3. Division of Surgery, Queen Elizabeth Hospital, Woodville South, Australia

4. University of Adelaide Discipline of Surgery, Adelaide, Australia

5. Department of Academy of Endosurgery, Christchurch, New Zealand

6. Department of Colon and Rectal Surgery, Royal Prince Alfred Hospital, Sydney, Australia

7. Surgical Outcomes Research Centre, University of Sydney, Sydney, Australia

8. Department of Colon and Rectal Surgery, Royal Brisbane and Women's Hospital, Herston, Australia

Abstract

Abstract Background A retrospective analysis of age-related postoperative morbidity in the Australia and New Zealand prospective randomized controlled trial comparing laparoscopic and open resection for right- and left-sided colonic cancer is presented. Methods A total of 592 eligible patients were entered and studied from 1998 to 2005. Results Data from 294 patients who underwent laparoscopic and 298 who had open colonic resection were analysed; 266 patients were aged less than 70 years and 326 were 70 years or older (mean(s.d.) 70·3(11·0) years). Forty-three laparoscopic operations (14·6 per cent) were converted to an open procedure. Fewer complications were reported for intention-to-treat laparoscopic resections compared with open procedures (P = 0·002), owing primarily to a lower rate in patients aged 70 years or more (P = 0·002). Fewer patients in the laparoscopic group experienced any complication (P = 0·035), especially patients aged 70 years or above (P = 0·019). Conclusion Treatment choices for colonic cancer depend principally upon disease-free survival; however, patients aged 70 years or over should have rigorous preoperative investigation to avoid conversion and should be considered for laparoscopic colonic resection. Registration number: NCT00202111 (http://www.clinicaltrials.gov).

Funder

Robert McLelland Trust

Trust Bank Canterbury

J. R. Mackenzie Trust

Johnson & Johnson Medical New Zealand

Johnson & Johnson Medical

The Canterbury Medical Research Foundation

The Health Research Council of New Zealand

National Health and Medical Research Council of Australia

Publisher

Oxford University Press (OUP)

Subject

Surgery

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