Type and Consequences of Short-Term Complications in Colon Cancer Surgery, Focusing on the Oldest Old

Autores de I3PT

• 

  Marisa Baré Mañas

  Autor

• Laura Mora López

  Autor

Participantes ajenos a I3PT

• Pera, M
• Collera, P
• Redondo, M
• Escobar, A
• Anula, R
• Quintana, JM
• CARESS-CCR Study Grp

Grupos de Investigación

• Recerca en cirurgia colorrectal

  

  Investigador

  Xavier Serra Aracil

Abstract

Older patients may experience postoperative more complications with serious consequences. This study analyzed in-hospital complications in 1976 patients undergoing surgery for colon cancer. Infections, anastomotic leakage, and cardiorespiratory failure were more common in older patients, while in-hospital mortality was nearly 10 times higher than in younger patients. Oldest patients should receive appropriate multidisciplinary functional preparation before the intervention. Background: While the proportion of colon cancer occurring in older patients is expected to increase, these patients may have more complications that may lead to serious consequences. The aim of this study was assess postoperative complications and their short-term consequences in colon cancer surgery according to age. Patients and Methods: Patients undergoing surgery for primary invasive colon cancer in 22 centers between June 2010 and December 2012 were included. Presurgical and surgical variables were analyzed, and in-hospital major postoperative complications and its most serious consequence (no relevant, transfusion, reintervention, admission to the intensive care unit, or death) were estimated according to age group. Chi-square tests were used to analyze the possible associations between variables and age groups. Results: Data from 1976 patients, mean (range) age 68 (24-97) years, 62% men, were analyzed; 52.2% were aged > 69 years and 17.7% were aged > 79 years. The complication rate was 25.3%, reaching 30.9% in those aged >= 80 years. Older age was associated with a higher rate of postoperative infections during the hospital stay. The most common surgical complication in patients aged > 85 years was dehiscence of the anastomosis (11.5%). About 5% of patients with major complications died in the hospital (11.1% of those aged 80-84 years and 14.3% aged > 85 years). Among patients aged > 85 years, 38.1% required transfusions. Conclusion: Older patients should receive appropriate functional preparation before the intervention, and when the risks of the intervention outweigh the potential benefits, a nonsurgical approach may be preferable. (C) 2019 Elsevier Inc. All rights reserved.

Keywords

• Colon cancer; Elderly patients; Muftidisciplinarity; Postoperative complications; Prehabilitation