Colorectal cancer surgery in octogenarians

Abstract

Objective: 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 50.2%, and rectum in 31.7%, Eleven patients underwent emergency surgery (17.5%). The most common surgical procedure was low anterior resection m 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 adenocarcmoma 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, 29.2%; p=0.0170). Length of total hospital stay was 14 (3-39) days, Surgical (p=0.0004) and medical (p=0.0282) 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.