Laparoscopic Colectomy for Nonagenarians, Preliminary Experience in National Taiwan University Hospital

Purpose. Over the past decade, laparoscopic colectomy has been widely used for patients with colorectal neoplasm. However, there is little data about laparoscopic surgery among nonagenarians. This study discusses our clinical experience of laparoscopic colectomy for nonagenarians in a single institute.
Methods. From January 2000 to July 2009, we performed a retrospective case control study of patients who underwent laparoscopic or open colectomy due to a primary colon tumor. Thirty-five patients were older than 90 years old. The demographics, tumor characteristics, surgical methods, lab data, morbidity, mortality, and survival were investigated and analyzed.
Results. Eleven patients underwent laparoscopic colectomy and eleven underwent open colectomy were enrolled. The mean age entering surgery was 92.3 versus 93.3. The most common operation procedure was a laparoscopic anterior resection (45%) versus open right hemicolectomy (27.3%). The average of hospital stay was 16.9 (8-39) days versus 23.9 (10-69) days. Four patients in laparoscopic group (36.4%) and five in open group (45.5%) suffered complications. There was one 30 days-mortality (9.1%) in laparoscopic group. The median follow-up interval was 19 versus 13 months and the five year survival rate was 54.6% versus 33.8%.
Conclusion. The short-tern and long-tern result of laparoscopic group are not worse than open group. The mortality and morbidity rates in our study are not higher than octogenarians or septuagenarians of other studies. For nonagenarians with colorectal neoplasm, laparoscopic colectomy is a feasible and safe option for selective patients.