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Complications of colorectal surgery
BMC Geriatrics volume 10, Article number: A14 (2010)
There is a more important incidence (73% males and 78% females) of neoplastic colorectal pathology in patients over 75. Old age is generally considered as a risk factor, whether in terms of morbidity or mortality. Several authors reported an increase of postoperative complications (25,5%-41,2% versus 16,3%-21,5%) in old patients [1, 2].
Falch C. reports a 30-day mortality of 12% in patients over the age of 80 against 3% of patients between 60 and 79 years. 
Age alone isn’t a promoting factor of complications in selected older patients .
Materials and methods
155 non selected patients have been operated on for colorectal carcinoma; 101 patients (65,15%) were over 70 (A Group), and 54 (34,85%) under 70 (B Group). We performed 30 left hemicolectomies, 66 right hemicolectomies, 2 transversectomies, 34 rectal resections, 21 sigmoidectomies, 2 Miles’s amputations. 33.66% patients of A group had associated pathologies (diabetes, vascular and vasculocerebral diseases) . In 11 patients a palliative operation was performed. 27 patients of A group were operated on in emergency.
In A group postoperative complications were 5,9% and in B group 5,5% including an intraoperative ureter injury, immediately repaired. Anastomotic dehiscence occurred in 1,98% of A group (patients operated on in emergency) and 0% of B group. Mortality was 1,98% in A group.Two reoperations were performed.
Long term outcomes are similar whether in patients over 70 or under 70, while it’s only the lower ability of the former to react against complications that produce a careful evaluation of single patient. Prevention or reduction of complications is possible by carrying out some measures and precautions.
Marusch F, Koch A, Schmidt U, Zippel R, Gastmeier J, Ludwig K, Geissler S, Pross M, Gastinger I, Lippert H: Impact of age on the short-term postoperative outcome of patients undergoing surgery for colorectal carcinoma. Int J Colorectal Dis. 2002, 17 (3): 177-84. 10.1007/s003840100344.
Braun L: Prognosis of colorectal cancer in patients over 80. Dtsch Med Wochenschr. 1986, 111 (49): 1869-73. 10.1055/s-2008-1068727.
Falch C, Kratt T, Beckert S, Kirschniak A, Zieker D, Königsrainer I, Löb S, Hartmann JT, Königsrainer A, Brücher BL: Surgery of colorectal carcinoma in patients aged over 80. Onkologie. 2009, 32 (1-2): 10-6. 10.1159/000184580. Epub 2009 Jan 20.
Capra F, Scintu F, Zorcolo L, Casula G: Surgical treatment for colorectal cancer in patients over 80 years. Short and long term results. Minerva Chir. 2003, 58 (4): 515-22.
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Minutolo, V., Buttafuoco, A., Gagliano, G. et al. Complications of colorectal surgery. BMC Geriatr 10, A14 (2010). https://doi.org/10.1186/1471-2318-10-S1-A14
- Public Health
- Postoperative Complication
- Colorectal Carcinoma
- Single Patient