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  • Title: [Radical resection of colorectal carcinoma in the oldest old].
    Author: Kruschewski M, Germer CT, Rieger H, Buhr HJ.
    Journal: Chirurg; 2002 Mar; 73(3):241-4. PubMed ID: 11963498.
    Abstract:
    INTRODUCTION: The percentage of old people with colorectal cancer is steadily increasing in Western industrialized countries. Since there are only a few reports on the extent of surgery, it is unclear whether radical lymphadenectomy can also be safely performed as a standard operation in this age group. METHODS: In a prospective study, we analyzed all patients who were > or = 80 years of age at the time of surgery and who were submitted to surgery between 1/95 and 12/00 due to a colorectal carcinoma. Target parameters were postoperative morbidity and mortality. RESULTS: Fifty-seven of 665 patients (8.6%) were > or = 80 years of age. The median age was 85 years (range: 80-92). The gender ratio was 1:1.6 (G:E). Palliative surgery was performed in 19 of 57 patients. The remaining 38 patients underwent curative radical lymphadenectomy; 32 were elective and 6 emergency procedures. Mean ASA scores were 2.1 +/- 0.3 and 2.5 +/- 0.6. The following operations were performed: 13 right-sided and 15 left-sided hemicolectomies, 5 rectal resections, 3 rectal extirpations and 2 Hartmann's procedures. Two anastomotic insufficiencies (6%) had a complication-free course after revision. The rate of major surgical complications was 11%, that of internal complications 16%. Three patients (8%) died, one after an elective procedure and two after emergency laparotomy. One of the latter was an 89-year-old woman who refused to undergo a revision due to bleeding after Hartmann's procedure. Pneumonia and myocardial infarction were the cause of death in the other two patients. CONCLUSION: Radical resection can be safely performed even at an advanced age. Since age-corrected survival is comparable to that of younger patients, surgery should be performed in the elderly under elective conditions according to oncological criteria.
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