Clinical Comparision Of Laparoscopic And Conventional Open Surgery In Elder Patients With Colorectal Cancer

Objective: To evaluate the safety, radical effects,efficacy and advantages of laparoscopic colorectal surgery for the elder patients with colorectal cancer.Methods: Comorbidities, ASA(American society of anesthesiology score)class, operation safety, oncological clearance , postoperative recovery, expenditure and short-term outcome of 31 patients aged 70 years and over who underwent laparoscopic colorectal surgery(LAP group)were analyzed retrospectively and compared with those of 40 patients aged 70 years and over who performed conventional laparotomy surgery(OPEN group).Results: No difference was seen between the two groups on their age, gender, diagnosis, comorbidities composition and ASA class(American society of anesthe- siology score). The laparoscopic group had a longer mean operation time than the open group (210.65±64.778min VS 153.55±48.193min, P<0.05).With gradually development of laparoscopic procedure , operation time decreased obviously(223.57±53.981min of the early 21 cases VS 183.51±55.660min of the late cases, P<0.05). Time of the postoperative bowel function recovery and food resumptioin LAP group were (3.72±1.230) days and (4.75±1.383) days, respectively, which were significantly less than those of OPEN group (4.50±1.013) days and (5.75±1.717)days (P<0.05). The postoperative draining and hospitalization days, length of specimen ,lymph node numbers and Dukes staging of the laparoscopic surgery group was respectively equivalent to that of laparotomy surgery.(P > 0. 05). There were 8(25.80%)cases of complications in the LAP group,13(32.50%)cases in the OPEN group. There was no difference between them. But there were five cases of severe pulmonary infection in the OPEN group, two cases in the LAP group. No difference was seen between the two groups on their medical expenses. Comparing with laparotomy group, there was higher operation spends and hospitalization costs in laparoscopic surgery group.Conclusion: Laparoscopic colorectal surgery is safe and beneficial to the patients older than age 70 and it should be adopted widely.