The First Year After Colorectal Surgery in the Elderly

Verena N. N. Kornmann; Jeroen L.A. van Vugt; Anke B. Smits; Bert van Ramshorst; Djamila Boerma

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자료유형: 학술저널

저자정보: Verena N. N. Kornmann (St. Antonius Hospital) Jeroen L.A. van Vugt (St. Antonius Hospital) Anke B. Smits (St. Antonius Hospital) Bert van Ramshorst (St. Antonius Hospital) Djamila Boerma (St. Antonius Hospital)

저널정보: 대한대장항문학회 Annals of Coloproctology Annals of Coloproctolgy Vol.33 No.4

발행연도: 2017.1

수록면: 134 - 138 (5page)

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Purpose: Surgery for colorectal malignancy is increasingly being performed in the elderly. Little is known about the impact of complications on late mortality. This study aimed to analyze whether a complicated postoperative course affects the 1-year survival in elderly patients. Methods: All consecutive patients older than 75 years of age who underwent colorectal cancer surgery between January 2009 and April 2013 were included in this study. The main outcome was mortality at 1 year after surgery. Logistic regression analyses were performed to determine risk factors for a poor outcome (mortality) after survival of the early postoperative course of surgery at 1-year follow-up. Patients who died within 30 days postoperatively were excluded from analysis. Results: The early mortality rate was 6.3% (n = 15), and 2 patients died during follow-up as a result of complications after a second surgery. A total of 223 patients survived the perioperative period and were included in this study. Twenty-two patients (9.9%) died during the first year of follow-up. Stage IV disease (P = 0.002), complications of primary surgery (P = 0.016), and comorbidity (P = 0.050) were risk factors for 1-year mortality. Intensive care unit stay, reoperation and readmission were not associated with a worse 1-year outcome. Conclusion: Elderly patients with stage IV disease at the time of surgery, comorbidity, and postoperative complications are at risk for mortality during the first year after surgery. A patient-tailored approach with special attention to perioperative care should be considered in the elderly.

참고문헌 (20)

참고문헌 신청

Etzioni DA / 2009 / Impact of the aging population on the demand for colorectal procedures / Dis Colon Rectum 52:583~590

Chang GJ / 2007 / Are we undertreating rectal cancer in the elderly? An epidemiologic study / Ann Surg 246:215~221

2000 / Surgery for colorectal cancer in elderly patients: a systematic review. Colorectal Cancer Collaborative Group / Lancet 356:968~974

Manceau G / 2012 / Comparative outcomes of rectal cancer surgery between elderly and non-elderly patients: a systematic review / Lancet Oncol 13:e525~e536

Dekker JW / 2011 / Importance of the first postoperative year in the prognosis of elderly colorectal cancer patients / Ann Surg Oncol 18:1533~1539

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