Short-term effect of laparoscopy in combination with fast-track colorectal surgery on colorectal cancer in the elderly

Objective To evaluate the safety and feasibility of laparoscopy in combination with fast-track colorectal surgery (FTCS) in the treatment of colorectal cancer in the elderly. Methods A total of 123 patients were randomly divided into 3 groups: the laparoscopy plus FTCS group (n=41), the laparoscopy group (n=41) and the laparotomy group (n=41). Parameters for measuring surgical quality, recovery and postoperative complications were analysed. Results No significant differences were found in age, gender, tumor location, anesthesia ASA classification, American Joint Committee on Cancer (AJCC) Tumor Node Metastasis (TNM) staging, Eastern Cooperative Oncology Group (ECOG) score or complications between the three groups (P>0.05 for all). There were no differences in blood loss, operative time, time required to resume defecation or number of lymph nodes dissected between the laparoscopy plus FTCS group and the laparoscopy or laparotomy group (P>0.05 for all), but time taken to initiate postoperative ambulation, time taken to resume flatulence, time taken to start intake of liquid food and length of hospital stay were shorter in the laparoscopy plus FTCS group than in the other groups (P<0.05 for all). The incidence of postoperative complications was 12.2% or 5/41 in the laparoscopy plus FTCS group, which was lower than in the laparoscopy group (34.1% or 14/41) and in the laparotomy group (68.3% or 28/41) (χ2=5.549 and 28.826, P=0.018 and 0.01, respectively), a statistically significant difference was also found between the latter two groups (χ2=9.567, P=0.002). Conclusions Laparoscopy in combination with FTCS is safe and effective in the treatment of colorectal cancer in the elderly. Key words: Colorectal neoplasms; Laparoscopes; Colorectal surgery