Table 1 Study and patient characteristics (original studies included in this review)
Original study | Country and setting | Study-design | Population | Sample | Age median (range) or mean (±SD), in y | Inclusion criteria (original study) | Exclusion criteria (original study) |
|---|---|---|---|---|---|---|---|
Zeng 2017 [16] | China Monocentric, academic | Database analysis | Colorectal Laparoscopic Cancer | 94 ERP ≥ 75y 157 CC ≥75y | 78 (75–88) 78 (75–90) | ≥75y Laparoscopic colorectal surgery Colorectal cancer | Emergency surgery Non-radical resection TNM stage IV Multi-organ resection |
Pirrera 2017 [17] | Italy Monocentric, non-academic | Database analysis | Colorectal Laparoscopic Cancer/Benign | 203 ERP > 75y 175 ERP 66-75y 211 ERP ≤65y | 80 (range NR) 69 (range NR) 56 (range NR) | Colorectal resection Scheduled for laparoscopic approach | Emergency surgery Palliative procedure |
Forsmo 2017 [18] | Norway Monocentric, academic | Secondary analysis of RCT data | Colorectal Open/Lap Cancer/Benign | 19 ERP ≥ 80y 56 ERP 66-79y 79 ERP ≤ 65y | 83 (80–89) 72 (66–78) 58 (23–65) | ≥18y Colorectal surgery With or without stoma Malignant or benign | Multi-organ resection ASA 4 Emergency surgery Impaired mental capacity |
Braga 2017 [19] | Peri-operative Italian Society Registry (11 hospitals) | Database analysis | Colorectal Open/Lap Cancer/Benign | 93 ERP > 80 y 117 ERP 76-80y 105 ERP 71-75y | 84 (SD ± 3) 77 (SD ± 2) 73 (SD ± 1) | >70y Elective colorectal surgery | / |
Braga 2016 [20] | Peri-operative Italian Society Registry (11 hospitals) | Database analysis | Colorectal Open/Lap Cancer/Benign | 167 ERP ≥ 70y, ASA 1–2 162 ERP ≥ 70y, ASA 3–4 279 ERP <70y, ASA 1–2 98 ERP <70y, ASA 3–4 | 77 (SD ± 4.6) 78 (SD ± 5.3) 58 (SD ±9) 63 (SD ±5.7) | Elective colorectal surgery | / |
Gonzalez-Ayora 2016 [21] | Spain Multicentric, academic | Database analysis | Colorectal Open/Lap Cancer/Benign | 188 ERP ≥ 70y | 79 (70–93) | ≥70y Colorectal surgery | Emergency surgery Palliative procedure |
Pedziwiatr 2015 [22] | Poland Monocentric, academic | Database analysis | Colorectal Laparoscopic Cancer | 34 ERP ≥ 80y 43 ERP ≤55y | 83 (IQR 82–87) 50 (IQR 44–54) | ≥80y or ≤ 55y Laparoscopic colorectal surgery Colorectal adenocarcinoma | Emergency surgery Multi-organ or transanal resection Concomitant IBD ICU stay after surgery |
Kisialeuski 2015 [23] | Poland Monocentric, academic | Prospective observational cohort study | Colorectal Laparoscopic Cancer | 49 ERP > 65y 43 ERP ≤65y | 76.3 (SD NR) 55.8 (SD NR) | Laparoscopic colorectal surgery Colorectal cancer | Emergency surgery Multi-organ resection |
Jia 2014 [24] | China Monocentric, academic | RCT | Colorectal Open Cancer | 117 ERP ≥ 70y 116 CC ≥70y | 75.7 (SD ± 4.2) 74.8 (SD ±4.0) | ≥70y Admitted for open curative resection Colorectal carcinoma | Dementia, Parkinson, alcohol intake ≥250 g/d, long term sleeping pills or anxiolytics, anaesthesia ≤30d Intra-operative blood transfusion or ICU stay after surgery |
Keller 2013 [25] | USA Monocentric, academic | Database analysis | Colonic Laparoscopic Cancer/Benign | 153 ERP ≥ 70y 302 ERP <70y | 77.9 (SD ± 6.1) 52.4 (SD ±13.7) | Elective laparoscopic colon resection (conversions included) | Incomplete medical or financial records |
Feroci 2013 [26] | Italy Monocentric, non-academic | Database analysis | Colorectal Open/Lap Cancer/Benign | 204 ERP ≥ 75y 402 ERP <75y | Overall: 70 (30–94) | Elective colorectal resection (multiple previous laparotomies are included) ASA grades 1 to 4 | Medically unfit for surgery Cancer with distant metastasis <18y or pregnant |
Baek 2013 [27] | Korea Monocentric, academic | Prospective observational cohort study | Colorectal Laparoscopic Cancer | 77 ERP ≥ 70y 226 ERP <70y | 74.8 (SD ± 4.2) 56.7 (SD ±8.9) | Laparoscopic or robotic surgery Colorectal cancer | Emergency surgery ASA 4 ICU stay after surgery Conversion (laparoscopic to open) |
Wang 2012 [28] | China Monocentric, academic | RCT | Colorectal Laparoscopic Cancer | 40 ERP ≥ 65y 38 CC ≥65y | 71 (65–81) 72 (65–82) | ≥ 65y Laparoscopic colorectal resection Colorectal cancer | Distant metastasis (involving pelvic, urethra of iliac vessel invasion) Poor cardiopulmonary function |
Pawa 2012 [29] | UK Monocentric, academic | Database analysis | Colorectal Open/Lap Cancer/Benign | 130 ERP ≥ 80y 558 ERP < 80y | 83 (80–95) 66 (17–79) | Colorectal resection | None |
Walter 2011 [30] | UK Monocentric, non-academic | Database analysis; retrospective control group | Colorectal Open/Lap Cancer/Benign | 68 ERP ≥ 80y 332 ERP < 80y 200 CC | Overall: 67 (IQR 56–77) 69 (IQR 57–78) | Major colorectal resections First 400 consecutive, non-selected, patients managed within an ERP Last 200 patients pre-ERP | Emergency surgery |
Kahokehr 2011 [31] | New Zealand Monocentric, academic | Prospective observational cohort study | Colonic Open/Lap Cancer/Benign | 22 ERP > 75y 78 ERP ≤75y | Overall: 67.5 (IQR 31–92) | Elective colonic surgery within an ERP | Rectal cancer ≤15 cm from the anal verge, patients requiring a stoma or unable to participate (language, cognitive impairment, ASA ≥4) |
Rumstadt 2009 [32] | Germany FTCII programme (24 hospitals) | Database analysis | Colonic Open/Lap Cancer/Benign | 207 ERP ≥ 80y 535 ERP 70-79y | 74.7 (70–79.9) 83.4 (80–95.7) | ≥ 70y Elective colonic resection | Emergency surgery Perforation or abscess with septic inflammatory response syndrome |
Hendry 2009 [33] | UK, Norway, Sweden, The Netherlands Multicentric, academic | Database analysis | Colorectal Open Cancer/Benign | 194 ERP ≥ 80y 839 ERP <80 | Overall: 59 (IQR 69–78) | Elective open colorectal surgery with formation of an anastomosis In case of rectal cancer: tumour in the upper 1/3 of the rectum and allows anastomosis in the middle 1/3 ASA grade 1 to 4 | Total mesorectal excision |
Scharfen-berg 2007 [34] | Germany Monocentric, academic | Prospective observational cohort study | Colonic Open/Lap Cancer/Benign | 74 ERP > 70y | 74 (71–88) | > 70y Elective colonic resection Benign or malignant disease | Not operated on electively |
Senagore 2003 [35] | USA Monocentric, academic | Retrospective observational cohort study | Colonic Open/Lap Cancer/Benign | 50 ERP ≥ 70y, lap 123 ERP ≥ 70y, open 181 ERP <60y, lap 122 ERP <60y, open | 77.5 (SE ± 4.6) 77.8 (SE ± 5.4) 42.4 (SE ±12.3) 46.7 (SE ±9.8) | 4 age-matched cohorts Elective segmental colectomy Laparoscopic/open when excluded for laparoscopic approach based on standardised criteria | Prior major abdominal surgery Incomplete data |
Bardram 2000 [36] | Denmark Monocentric, academic | Retrospective observational cohort study | Colonic Laparoscopic Cancer/Benign | 39 ERP ≥ 70y, lap 11 ERP ≥70y, converted | Overall: 81 (70–93) | Laparoscopic colonic resection Laparoscopic surgery 70–75y: benign disease or malignant disease with severe cardiopulmonary disease > 75y: malignant disease | Not elective Tumours in the transverse colon or rectum Patients not self-caring and not admitted directly from home |