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The purpose of this study was to evaluate the impact of laparoscopic colorectal resection on short-term postoperative outcome in elderly patients.A series of 535 patients with colorectal disease who had been randomly assigned to laparoscopic (n = 268) or open (n = 267) resection was analyzed. A total of 201 patients (37.6 percent) were elderly (aged 70 years or older) and 334 patients (62.4 percent) were younger than aged 70 years. Follow-up for postoperative morbidity was performed for 30 days after hospital discharge.Elderly patients had a higher American Society of Anesthesiologists score compared with younger patients in both the laparoscopic and open groups (P= 0.0001). In the open group, elderly patients had higher morbidity rate (37.5vs.23.9 percent;P= 0.02) and longer length of hospital stay (13vs.10.6;P= 0.007) compared with younger patients. In the laparoscopic group, morbidity rate (20.2vs.15.1 percent) and length of hospital stay (9.5vs.9.1) were similar in elderly and younger patients. In elderly patients, the laparoscopy-reduced morbidity rate (20.2vs.37.5 percent;P= 0.01) and length of hospital stay (9.5vs.13;P= 0.001) compared to the open approach. In younger patients, the advantages of the laparoscopic approach on morbidity rate (15.1vs.23.9 percent;P= 0.06) and length of stay (9.1vs.10.6;P= 0.004) were less pronounced.Laparoscopy improved short-term postoperative outcome more in elderly than in younger patients. Advanced age was associated with higher morbidity and longer length of stay only in patients who underwent open colorectal surgery.