Laparoscopic Versus Open Surgery for Rectal Cancer in Elderly Patients

With the increase of life expectancy, surgical intervention for rectal cancer is more and more frequently performed in the elderly. It is well accepted that laparoscopic surgery is of advantage, but not widely recognized in old patients with rectal cancer. In order to assess laparoscopic surgery for rectal cancer in elderly patients, we performed this study. This retrospective study was designed to compare short-term outcomes between laparoscopic surgery and open surgery in elderly patients with rectal cancer, which may give some useful guidance in the clinical practice. Thirty-seven patients with rectal cancer aged 75 and older undergoing laparoscopic surgery were matched with 37 counterparts undergoing open surgery. Criteria of matching included general information and preoperative status. Patients in the laparoscopic surgery and open surgery groups were comparable for the matching criteria. Compared with the open surgery group, estimated blood loss (P=0.048) and intraoperative transfusion (P=0.042) were less in the laparoscopic surgery group. As to short-term postoperative outcomes, duration of postoperative hospital stay was shorter (P = 0.039) and overall complication (P = 0.032) and wound complication (P = 0.038) was less in the laparoscopic surgery group than in the open surgery group. In conclusion, considering the operative variables and short-term outcomes, laparoscopic surgery is safe and seems superior to open surgery in elderly patients with rectal cancer. However, further studies with more patients are needed to confirm the results and assess long-term results.