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

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). Copyright © 2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.