Background/Objectives:Life expectancy for people in their 60s is 24.3 years in high-income countries. Health systems face the burden of disease in the elderly population and must assess the impact of treatments such as major surgery. The aim of this study is to quantify the impact of advanced age on short-term postoperative outcomes after resective colorectal surgery (RCRS).Methods: All patients who underwent RCRS at our institution between July 2022 and November 2023 were entered into a database. Preoperative, perioperative, and early (within 30 days) postoperative data were recorded. Patients were categorized into a young group (under 75 years, YG) and an elderly group (over 75 years, EG). A retrospective comparative analysis of postoperative outcomes was performed between the two groups; postoperative complications were graded according to the Clavien classification.Results: Fifty-three and ninety-five patients were in the EG and YG, respectively. Indications for RCRS was cancer in 83% of EG patients and 61.1% of YG patients (p= 0.006), and the clinical presentation, localization, and rate of neoadjuvant treatment in oncological patients were comparable. Another indication for RCRS was complicated diverticular disease (17% of EG patients and 38.9% of YG patients;p= 0.006). With respect to the baseline characteristics, the ASA and CCI scores were worse in the EG (p= 0.001). No significant differences in the surgical approach, mini-invasive approach, conversion rate, definitive stoma creation, or number of harvested lymph nodes were found between the two groups. Overall, EG reported a higher relative risk (RR) of short-term postoperative complications (1.64, CI: 1.03–2.63), but no significant differences were found in terms of grade ≥3 complications (RR: 0.9, CI: 0.23–3.44). In the EG, a higher risk of ICU admission (RR:2.69, CI: 1.5–4.8) and a one-day longer postoperative hospital stay (6 vs. 5 days) were reported.Conclusions: Advanced age does not seem to contraindicate RCRS, especially in colorectal cancer patients. The impact of elderly age on short-term outcomes seems to be minimal and acceptable.
背景/目的：在高收入国家，60多岁人群的预期寿命为24.3年。医疗系统面临老年人群疾病负担，必须评估重大手术等治疗措施的影响。本研究旨在量化高龄对结直肠切除术后短期结局的影响。 方法：将2022年7月至2023年11月期间在本机构接受结直肠切除术的所有患者纳入数据库。记录术前、围术期及术后早期（30天内）数据。患者分为年轻组（75岁以下，YG）和老年组（75岁以上，EG）。对两组术后结局进行回顾性比较分析；术后并发症按Clavien分级系统进行分级。 结果：EG组53例，YG组95例。结直肠切除术的适应症在EG组83%为癌症，YG组61.1%为癌症（p=0.006），肿瘤患者的临床表现、病灶定位及新辅助治疗率具有可比性。另一适应症为复杂性憩室病（EG组17%，YG组38.9%；p=0.006）。基线特征方面，EG组的ASA评分和CCI评分更差（p=0.001）。两组在手术方式、微创手术比例、中转开腹率、永久性造口率及淋巴结清扫数量方面均无显著差异。总体而言，EG组术后短期并发症的相对风险更高（RR:1.64，CI:1.03-2.63），但≥3级并发症无显著差异（RR:0.9，CI:0.23-3.44）。EG组入住ICU风险更高（RR:2.69，CI:1.5-4.8），术后住院时间延长一天（6天 vs. 5天）。 结论：高龄似乎并非结直肠切除术的禁忌证，尤其对于结直肠癌患者。高龄对短期结局的影响较小且可接受。
肿瘤(癌症)患者之家