Evaluation of laparoscopic versus open colorectal surgery in elderly patients more than 70 years old: LTP90

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Aim:Laparoscopic colorectal surgery (LC) has been demonstrated to be superior compared to the open approach. Controversy persists however, regarding the benefit of LC in the elderly due to increase in operative time. The aim of our study was to compare short-term outcomes of LC versus open colorectal surgery (OC) in elderly patients.Method:Patients > 70 years old that underwent elective LC between 2005 and 2008, were compared with controls who underwent OC. Data was extracted from aprospectively collected database.Results:Seven hundred and twenty-seven patients underwent colorectal resection over this 4 year period (LC n = 225, OC n = 502). The laparoscopic arm was characterised by shorter incisions (LC 6.0 cm vs OC 12.0 cm, P < 0.001) but longer operating times (LC 125 min vs OC 85 min, P < 0.001). There were no significant differences in terms of recovery with similar mean narcotic use (LC 2.2 days vs OC 2.3 days, P = 0.832), mean recovery of bowel function (LC 3.8 days vs OC 4.5 days, P = 0.14) and median length of stay (LC 6 days, OC 7 days; P = 0.725). Post-operative morbidity and 30 day mortality were similar.Conclusion:In this series, LC in elderly patients was safe and not associated with higher morbidity or mortality when compared to OC.

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