Annals of Coloproctology

Original Articles

Oncologic outcomes and associated factors of colon cancer patients aged 70 years and older: Byeo Lee Lim, In Ja Park, Jun-Soo Ro, Young Il Kim, Seok-Byung Lim, Chang Sik Yu; Received June 7, 2023 Accepted September 11, 2023 Published online August 5, 2024; DOI: https://doi.org/10.3393/ac.2023.00367.0052 [Epub ahead of print]

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Purpose
The aim of this study was to examine the prognosis and associated risk factors, including adjuvant chemotherapy (CTx), in elderly patients with colon cancer.
Methods
This retrospective study included patients who underwent radical resection for colon cancer between January 2010 and December 2014 at Asan Medical Center. The effects of stage, risk factors, and chemotherapy on overall survival (OS) and recurrence-free survival (RFS) were compared in patients aged ≥70 and <70 years.
Results
Of 3,313 patients, 933 (28.1%) was aged ≥70 years. Of the 1,921 patients indicated for adjuvant CTx, 1,294 of 1,395 patients (92.8%) aged <70 years and 369 of 526 patients (70.2%) aged ≥70 years received adjuvant CTx. Old age (≥70 years) was independently associated with RFS in overall cohort. Among patients aged ≥70 years indicated for adjuvant CTx, the 5-year OS (81.6% vs. 50.4%, P<0.001) and RFS (82.9% vs. 67.4%, P=0.025) rates were significantly higher in those who did than did not receive adjuvant CTx. Additionally, adjuvant CTx was confirmed as independent risk factor of both OS and RFS in patients aged ≥70 years indicated for adjuvant CTx.
Conclusion
Old age was associated with poor RFS and adjuvant CTx had benefits in OS as well as RFS in elderly patients eligible for adjuvant CTx.

Citations

Citations to this article as recorded by

Immunological changes and recovery-related factors in older patients with colon cancer: A pilot trial
Byeo Lee Lim, Young Il Kim, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, Yousun Ko, Kyung Won Kim, In Ja Park
Journal of Geriatric Oncology.2025; 16(3): 102200. CrossRef
Stage II-III colorectal cancer in geriatric patients: Clinicopathological features and chemotherapy utilization
Yakup Duzkopru, Özlem Doğan
Turkish Journal of Clinics and Laboratory.2025; 16(1): 118. CrossRef
Early detection of anastomotic leakage in colon cancer surgery: the role of early warning score and C-reactive protein
Gyung Mo Son
Annals of Coloproctology.2024; 40(5): 415. CrossRef
Efficacy of Neoadjuvant Hypofractionated Chemoradiotherapy in Elderly Patients with Locally Advanced Rectal Cancer: A Single-Center Retrospective Analysis
Jae Seung Kim, Jaram Lee, Hyeung-min Park, Soo Young Lee, Chang Hyun Kim, Hyeong Rok Kim
Cancers.2024; 16(24): 4280. CrossRef

Malignant disease,Prognosis and adjuvant therapy,Functional outcomes,Colorectal cancer,Postoperative outcome & ERAS

Clinical validation of implementing Enhanced Recovery After Surgery protocol in elderly colorectal cancer patients: Wooree Koh, Chul Seung Lee, Jung Hoon Bae, Abdullah Al-Sawat, In Kyu Lee, Hyeong Yong Jin; Ann Coloproctol. 2022;38(1):47-52. Published online July 21, 2021; DOI: https://doi.org/10.3393/ac.2021.00283.0040

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15 Citations

Abstract PDF Supplementary Material

Purpose
The aim of this study was to evaluate the safety and feasibility of applying enhanced recovery after surgery (ERAS) protocol in elderly colorectal cancer patients.
Methods
The medical records of patients who underwent elective colorectal cancer surgery at our institution, from January 2017 to December 2017, were reviewed. Patients were divided into 2 groups: the young group (YG, patients aged 70 and under 70 years) and the old group (OG, patients over 70 years old). Perioperative outcomes and length of hospital stay were compared between both groups.
Results
In total, 335 patients were enrolled; 237 were YG and 98 were OG. Despite the poorer baseline characteristics of OG, the perioperative outcomes were similar. Length of hospital stay was not different between the groups (YG, 5 days vs. OG, 5 days; P=0.320). When comparing the postoperative complications using the comprehensive complication index (CCI), there was no significant difference (YG, 8.0±13.2 vs. OG, 11.7±23.0; P=0.130). In regression analysis, old age (>70 years) was not a risk factor for high CCI in all patients. In multivariate analysis, C-reactive protein (CRP) level on postoperative day (POD) 3 to 4 was the only strong predictive factor for high CCI in elderly patients.
Conclusion
Implementing the ERAS protocol in patients aged >70 years is safe and feasible. High CRP (≥6.47 mg/dL) on POD 3 to 4 can be used as a safety index to postpone discharge in elderly patients.

Citations

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Perioperative outcomes of laparoscopic low anterior resection using ArtiSential® versus robotic approach in patients with rectal cancer: a propensity score matching analysis
I. K. Kim, C. S. Lee, J. H. Bae, S. R. Han, W. Alshalawi, B. C. Kim, I. K. Lee, D. S. Lee, Y. S. Lee
Techniques in Coloproctology.2024;[Epub] CrossRef
Challenging issues of implementing enhanced recovery after surgery programs in South Korea
Soo-Hyuk Yoon, Ho-Jin Lee
Anesthesia and Pain Medicine.2024; 19(1): 24. CrossRef
Effects of the enhanced recovery after surgery (ERAS) protocol on the postoperative stress state and short‐term complications in elderly patients with colorectal cancer
He Han, Rong Wan, Jixiang Chen, Xin Fan, LiWen Zhang
Cancer Reports.2024;[Epub] CrossRef
Sex Disparities in Rectal Cancer Surgery: An In-Depth Analysis of Surgical Approaches and Outcomes
Chungyeop Lee, In Ja Park
The World Journal of Men's Health.2024; 42(2): 304. CrossRef
Application of ERAS in older patients with gastric cancer
Kuanxuan You, He Han
Medicine.2024; 103(22): e38409. CrossRef
Clinical outcomes and future directions of enhanced recovery after surgery in colorectal surgery: a narrative review
Ji Hyeong Song, Minsung Kim
The Ewha Medical Journal.2024;[Epub] CrossRef
Correlation between inflammatory markers and enhanced recovery after surgery (ERAS) failure in laparoscopic colectomy
Ji Hyeong Song, Yoonsoo Shin, Kyung Ha Lee, Ji Yeon Kim, Jin Soo Kim
Surgery Today.2024;[Epub] CrossRef
Beyond the Operating Room: A Narrative Review of Enhanced Recovery Strategies in Colorectal Surgery
Hamed Ibrahim Hamed Albalawi, Rawshan Khalid A Alyoubi, Nawaf Mohsen Mubarak Alsuhaymi, Farha Abdullah K Aldossary, Alkathiry Abdulrahman Mohammed G, Fayez Mubarak Albishi, Jumana Aljeddawi, Fedaa Ahmed Omar Najm, Neda Ahmed Najem, Mohamed Mirza Ali Alma
Cureus.2024;[Epub] CrossRef
Impact of Early Oral Feeding on Postoperative Outcomes after Elective Colorectal Surgery: A Systematic Review and Meta-Analysis
Soo Young Lee, Eon Chul Han
Digestive Surgery.2024; : 1. CrossRef
Enhanced recovery after colorectal surgery is a safe and effective pathway for older patients: a pooling up analysis
Xu-Rui Liu, Xiao-Yu Liu, Bin Zhang, Fei Liu, Zi-Wei Li, Chao Yuan, Zheng-Qiang Wei, Dong Peng
International Journal of Colorectal Disease.2023;[Epub] CrossRef
Effects of preoperative bicarbonate and lactate levels on short-term outcomes and prognosis in elderly patients with colorectal cancer
Xiao-Yu Liu, Zi-Wei Li, Bin Zhang, Fei Liu, Wei Zhang, Dong Peng
BMC Surgery.2023;[Epub] CrossRef
The Latest Results and Future Directions of Research for Enhanced Recovery after Surgery in the Field of Colorectal Surgery
Min Ki Kim
The Ewha Medical Journal.2023;[Epub] CrossRef
Influence of the COVID-19 Pandemic on the Treatment Patterns and Outcomes of Colorectal Cancer
In Ja Park
The Ewha Medical Journal.2023;[Epub] CrossRef
Future direction of Enhanced Recovery After Surgery (ERAS) program in colorectal surgery
In Ja Park
Annals of Coloproctology.2022; 38(1): 1. CrossRef
Implementation and improvement of Enhanced Recovery After Surgery protocols for colorectal cancer surgery
Bo Yoon Choi, Jung Hoon Bae, Chul Seung Lee, Seung Rim Han, Yoon Suk Lee, In Kyu Lee
Annals of Surgical Treatment and Research.2022; 102(4): 223. CrossRef

Malignant disease,Rectal cancer, Prognosis and adjuvant therapy,Colorectal cancer

Effect of Adjuvant Chemotherapy on Elderly Stage II High-Risk Colorectal Cancer Patients: Yujin Lee, Inseok Park, Hyunjin Cho, Geumhee Gwak, Keunho Yang, Byung-Noe Bae; Ann Coloproctol. 2021;37(5):298-305. Published online July 6, 2021; DOI: https://doi.org/10.3393/ac.2020.00829.0118

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Abstract PDF

Purpose
Adjuvant chemotherapy (AC) is recommended for patients with stage II colorectal cancer with adverse features. However, the effect of adjuvant treatment in elderly patients with high-risk stage II colorectal cancer remains controversial. This study aimed to investigate the oncologic outcomes in elderly high-risk stage II colorectal cancer patients who underwent curative resection with or without AC.
Methods
Patients aged over 70 years having stage II colorectal adenocarcinoma with at least 1 adverse feature who underwent radical surgery between 2008 and 2017 at a single center were included. We compared recurrence-free survival (RFS) and overall survival (OS) between patients who received more than 80% of the planned AC cycle (the AC+ group) and those who did not receive it (the AC− group).
Results
The AC+ and AC– group contained 46 patients and 50 patients, respectively. The log-rank test revealed no significant intergroup differences in RFS (P = 0.083) and OS (P = 0.122). In the subgroup of 27 patients with more than 2 adverse features, the AC+ group (n = 16) showed better RFS (P = 0.006) and OS (P = 0.025) than the AC− group. In this subgroup, AC was the only significant factor affecting RFS in the multivariate analysis (P = 0.023). AC was significantly associated with OS (P = 0.033) in the univariate analysis, but not in the multivariate analysis (P = 0.332).
Conclusion
Among elderly patients with stage II high-risk colorectal cancer, the AC+ group did not show better RFS or OS than the AC− group. However, selected patients with more than 2 adverse features might benefit from AC.

Citations

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Tumor aggression-defense index–a novel indicator to predicts recurrence and survival in stage II-III colorectal cancer
Tong Wu, Lin Fang, Yuli Ruan, Mengde Shi, Dan Su, Yue Ma, Ming Ma, Bojun Wang, Yuanyu Liao, Shuling Han, Xiaolin Lu, Chunhui Zhang, Chao Liu, Yanqiao Zhang
Journal of Translational Medicine.2025;[Epub] CrossRef
A Prognostic Model Based on the Log Odds Ratio of Positive Lymph Nodes Predicts Prognosis of Patients with Rectal Cancer
Jian Li, Yu zhou Yang, Peng Xu, Cheng Zhang
Journal of Gastrointestinal Cancer.2024; 55(3): 1111. CrossRef
Complete Obstruction, a Real Risk Factor: A Comprehensive Study on Obstruction in Stage IIA Colon Cancer With Propensity Score Matching Analysis
Soo Young Oh, Chan Wook Kim, Seonok Kim, Min Hyun Kim, Young Il Kim, Jong Lyul Lee, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Chang Sik Yu
Clinical Colorectal Cancer.2024; 23(2): 135. CrossRef
Clinical implication of tissue carcinoembryonic antigen expression in association with serum carcinoembryonic antigen in colorectal cancer
Abdulmohsin Fawzi Aldilaijan, Young Il Kim, Chan Wook Kim, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Jihun Kim, Jun-Soo Ro, Jin Cheon Kim
Scientific Reports.2023;[Epub] CrossRef
Advances in the Treatment of Colorectal Cancer with Peritoneal Metastases: A Focus on Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy
Youngbae Jeon, Eun Jung Park
The Ewha Medical Journal.2023;[Epub] CrossRef
Oncologic outcomes in elderly patients who underwent hysterectomy for endometrial cancer: a multi-institutional survey in Kinki District, Japan
Tomohito Tanaka, Suguru Yamashita, Haruo Kuroboshi, Junya Kamibayashi, Atsushi Sugiura, Kaori Yoriki, Taisuke Mori, Kazuharu Tanaka, Aiko Nagashima, Michihide Maeda, Shoji Kamiura, Yukako Mizuno, Noriko Ohtake, Tomoyuki Ichimura, Taiki Kikuchi, Yuri Nobut
International Journal of Clinical Oncology.2022; 27(6): 1084. CrossRef
Does adjuvant chemotherapy improve outcomes in elderly patients with colorectal cancer? A systematic review and meta-analysis of real-world studies
Jianbing Chen, Chengda Zhang, Yajuan Wu
Expert Review of Gastroenterology & Hepatology.2022; 16(4): 383. CrossRef
Risk factors for recurrence in elderly patients with stage II colorectal cancer: a multicenter retrospective study
Takuki Yagyu, Manabu Yamamoto, Akimitsu Tanio, Kazushi Hara, Ken Sugezawa, Chihiro Uejima, Kyoichi Kihara, Shigeru Tatebe, Yasuro Kurisu, Shunsuke Shibata, Toshio Yamamoto, Hiroshi Nishie, Setsujo Shiota, Hiroaki Saito, Takuji Naka, Kenji Sugamura, Kuniyu
BMC Cancer.2022;[Epub] CrossRef
Effects of the Enhanced Recovery After Surgery (ERAS) Program for Colorectal Cancer Patients Undergoing Laparoscopic Surgery
Jeongwon Yeom, Hee-Sook Lim
Clinical Nutrition Research.2022; 11(2): 75. CrossRef
The Prognostic Reliability of Lymphovascular Invasion for Patients with T3N0 Colorectal Cancer in Adjuvant Chemotherapy Decision Making
Hayoung Lee, Seung-Yeon Yoo, In Ja Park, Seung-Mo Hong, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
Cancers.2022; 14(12): 2833. CrossRef
Is the oncological impact of vascular invasion more important in right colon cancer?
Gyung Mo Son
Journal of Minimally Invasive Surgery.2022; 25(2): 49. CrossRef
Molecular analyses of peritoneal metastasis from colorectal cancer
Chang Hyun Kim
Journal of the Korean Medical Association.2022; 65(9): 586. CrossRef
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Kyung Uk Jung, Hyung Ook Kim, Hungdai Kim
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Molecular Analyses in Peritoneal Metastasis from Colorectal Cancer: A Review-An English Version
Chang Hyun Kim
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Epidemiology, Risk Factors, and Prevention of Colorectal Cancer-An English Version
Kyung Uk Jung, Hyung Ook Kim, Hungdai Kim
Journal of the Anus, Rectum and Colon.2022; 6(4): 231. CrossRef
Adjuvant chemotherapy benefits on patients with elevated carcinoembryonic antigen in stage IIA colon cancer: a SEER-based analysis
Huabin Zhou, Songsheng Wang, Zhai Cai, Enming Qiu, Qianyun Chen, Xi Rao, Shuai Han, Zhou Li
International Journal of Colorectal Disease.2022; 37(12): 2481. CrossRef
Elderly High-Risk Stage II Colorectal Cancer Patients: Candidates for Improving Outcome?
Min Ki Kim
Annals of Coloproctology.2021; 37(5): 267. CrossRef

Malignant disease

Colorectal Cancer in Octogenarian and Nonagenarian Patients: Clinicopathological Features and Survivals: Soo Min Lee, Jun Sang Shin; Ann Coloproctol. 2020;36(5):323-329. Published online October 31, 2020; DOI: https://doi.org/10.3393/ac.2020.01.19.2

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16 Citations

Abstract PDF

Purpose
Elderly population will comprise a substantial proportion of colorectal cancer (CRC) patients. We examined patients older than 80 years according to their clinical and pathological characteristics to fully understand the elderly patients.
Methods
CRC patients, 60 years or older at diagnosis, admitted between 2009 and 2014 at our hospital were enrolled. The patients were divided into 2 groups: elderly (aged > 80 years, n = 133), and controls (aged 60 to 79 years, n = 596). Patient’s demographics, risk factors for prognosis of CRC, Clinicopathological parameters, treatment, and survival rates were compared.
Results
The mean ages were 83.9 and 64.8 years, respectively. Male-to-female ratio and tumor sidedness were comparable in both groups. Prognostic factors found in univariate analysis; differentiation, stage, lymphovascular invasion, and carcinoembryonic antigen showed no statistical difference. The microsatellite instability status and number of retrieved lymph nodes were also similar (17.2 vs 21.6, P = 0.505). A significant difference was found in the treatment approach for chemotherapy as the elderly patients with stage III and IV tend to have omitted adjuvant (43.6% vs. 92.8%, P < 0.001) or palliative (35.8% vs. 89.4%, P = 0.016) chemotherapy. Except in stage I, elderly patients showed significantly lower overall survival rates.
Conclusion
Current study shows far-elderly patients with CRC were less likely to receive standard treatments, which might have resulted in an inferior outcome. As the number of elderly patients with CRC increase, our results provide a basis for further clinical and molecular investigations of elderly CRC patients.

Citations

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Surgical risk and cause of death among octogenarian and nonagenarian patients with colorectal cancer: a Japanese multicenter study
Shintaro Hashimoto, Takashi Nonaka, Tetsuro Tominaga, Toshio Shiraishi, Keisuke Noda, Rika Ono, Makoto Hisanaga, Hiroaki Takeshita, Hidetoshi Fukuoka, Kazuo To Fukuoka, Kenji Tanaka, Masaki Kunizaki, Terumitsu Sawai, Keitaro Matsumoto
Japanese Journal of Clinical Oncology.2025; 55(4): 341. CrossRef
Characteristics, Treatment and Outcomes of Stage I to III Colorectal Cancer in Patients Aged over 80 Years Old
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Cancers.2025; 17(2): 247. CrossRef
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Melissa R. Yeo, Ioannis A. Voutsadakis
Journal of Clinical Medicine.2025; 14(4): 1099. CrossRef
Oncologic outcomes of surgically treated colorectal cancer in octogenarians: a comparative study using inverse probability of treatment weighting (IPTW)
Soo Young Oh, Jung Yun Park, Kwan Mo Yang, Seong-A Jeong, Yong Jae Kwon, Yun Tae Jung, Chung Hyeun Ma, Keong Won Yun, Kwang Hyun Yoon, Jae Young Kwak, Chang Sik Yu
BMC Gastroenterology.2025;[Epub] CrossRef
Mortality and morbidity after colorectal cancer resection surgery in elderly patients: a retrospective population-based study in Sweden
Maria Normann, Niklas Ekerstad, Eva Angenete, Mattias Prytz
World Journal of Surgical Oncology.2024;[Epub] CrossRef
Robot-assisted vs. laparoscopic right hemicolectomy in octogenarians and nonagenarians: an analysis of the US nationwide inpatient sample 2005–2018
Chien-Chang Lu, Chi-Tung Lu, Kai-Yen Chang, Wang Chun-Li, Chien-Ying Wu
Aging Clinical and Experimental Research.2024;[Epub] CrossRef
Can clinicopathologic high-risk features in T3N0 colon cancer be reliable prognostic factors?
Hyun Gu Lee, Young IL Kim, In Ja Park, Seok-Byung Lim, Chang Sik Yu
Annals of Surgical Treatment and Research.2023; 104(2): 109. CrossRef
Presentation, Molecular Characteristics, Treatment, and Outcomes of Colorectal Cancer in Patients Older than 80 Years Old
Ioannis A. Voutsadakis
Medicina.2023; 59(9): 1574. CrossRef
Octogenarian patients with colon cancer – postoperative morbidity and mortality are the major challenges
Øystein Høydahl, Tom-Harald Edna, Athanasios Xanthoulis, Stian Lydersen, Birger Henning Endreseth
BMC Cancer.2022;[Epub] CrossRef
Multidisciplinary treatment strategy for early rectal cancer
Gyung Mo Son, In Young Lee, Sung Hwan Cho, Byung-Soo Park, Hyun Sung Kim, Su Bum Park, Hyung Wook Kim, Sang Bo Oh, Tae Un Kim, Dong Hoon Shin
Precision and Future Medicine.2022; 6(1): 32. CrossRef
Oncological liver resection in elderly – A retrospective comparative study
Carina E. Riediger, Steffen Löck, Laura Frohneberg, Raphael Hoffmann, Christoph Kahlert, Jürgen Weitz
International Journal of Surgery.2022; 104: 106729. CrossRef
Direction of diagnosis and treatment improvement in colorectal cancer
In Ja Park
Journal of the Korean Medical Association.2022; 65(9): 540. CrossRef
Epidemiology, risk factors, and prevention of colorectal cancer
Kyung Uk Jung, Hyung Ook Kim, Hungdai Kim
Journal of the Korean Medical Association.2022; 65(9): 549. CrossRef
Epidemiology, Risk Factors, and Prevention of Colorectal Cancer-An English Version
Kyung Uk Jung, Hyung Ook Kim, Hungdai Kim
Journal of the Anus, Rectum and Colon.2022; 6(4): 231. CrossRef
Update on Diagnosis and Treatment of Colorectal Cancer
Chan Wook Kim
The Ewha Medical Journal.2022;[Epub] CrossRef
Comprehensive Approach for Older Cancer Patients: New Challenge in an Aging Society
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Annals of Coloproctology.2020; 36(5): 289. CrossRef

The Impact of the Outcome of Treating a High Anal Fistula by Using a Cutting Seton and Staged Fistulotomy on Saudi Arabian Patients: Bader Hamza Shirah, Hamza Asaad Shirah; Ann Coloproctol. 2018;34(5):234-240. Published online October 10, 2018; DOI: https://doi.org/10.3393/ac.2018.03.23

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14 Citations

Abstract PDF

Purpose
A cutting seton is used after a partial distal fistulotomy to treat patients with a high exrasphincteric fistula in ano to avoid fecal incontinence and recurrence. In Saudi Arabia, religious practices necessitate complete cleanness, which makes conditions affecting anal continence a major concern to patients affected by an anal fistula. Therefore, we aimed to evaluate the efficiency of the cutting seton in treating a high anal fistula among Saudi Arabians.
Methods
Between January 2005 and December 2014, a prospective study was done for 372 Saudi Arabian patients diagnosed as having a high anal fistula and treated with a cutting seton at Al-Ansar General Hospital, Medina, Saudi Arabia. 0-silk sutures were used. All patients underwent the same preoperative assessment, operative technique, and postoperative follow-up. Weekly, the seton was tightened in outpatient clinics.
Results
Two hundred ninety-eight patients (80.1%) were males and 74 (19.9%) females. The duration of symptoms varied from 3–21 months. The fistula healed completely in 363 patients (97.6%); 58 patients (15.6%) reported some degree of incontinence to flatus, but none to feces. In 9 patients (2.4%) the fistula recurred.
Conclusion
The utilization of the cutting seton method in the treatment of patients with a high anal fistula is highly efficient as it simultaneously drains the abscess, cuts the fistulous tract, and causes fibrosis along the tract. Treatment of a high anal fistula by using a staged fistulotomy with a cutting seton was very rewarding to Saudi Arabian patients who feared anal incontinence for religious reasons and was associated with low postoperative complication and recurrence rates.

Citations

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Cutting seton for the treatment of cryptoglandular fistula-in-ano: a systematic review and meta-analysis
J. Khamar, A. Sachdeva, T. McKechnie, Y. Lee, L. Tessier, D. Hong, C. Eskicioglu
Techniques in Coloproctology.2024;[Epub] CrossRef
Evaluation surgical strategies in perianal fistulas treatment: Efficacy draining seton compared to other surgical approaches; a case‐control study
Amir Ghasemlouei, Amirhosein Naseri, Ali Ashjaei, Shahryar Sadeghi, Amir Keshvari
Health Science Reports.2024;[Epub] CrossRef
Assessing the suitability of video-assisted anal fistula treatment for obese patients compared to conventional surgery: a question worth investigating
Xiao-Li Tang, Zi-Yang Xu, Jun Yang, Zhe Yang, Zhi-Gang Wang, Zheng-Yun Zhang, Jing Yao
International Journal of Colorectal Disease.2024;[Epub] CrossRef
Comparative Evaluation Between Cutting of the Intersphincteric Space vs Cutting Seton in High Anal Fistula: A Randomized Controlled Trial
Jiawei Qin, Yanlan Wu, Xueping Zheng, Kunlan Wu, Gongjian Dai, Yanyan Tan, Xu Yang, Yuqing Sun
Journal of the American College of Surgeons.2024; 239(6): 563. CrossRef
Fistulectomy and primary sphincteroplasty in complex anal fistula treatment: a hospital-based long-term follow-up study
Fakhrosadat Anaraki, Mohammad Reza Nikshoar, Arsh Haj Mohamad Ebrahim Ketabforoush, Rojin Chegini, Nasrin Borumandnia, Mehdi Tavallaei
Techniques in Coloproctology.2023; 27(2): 145. CrossRef
Exploring Health-Related Quality of Life in Patients with Anal Fistulas: A Comprehensive Study
Tudor Mateescu, Lazar Fulger, Durganjali Tummala, Aditya Nelluri, Manaswini Kakarla, Lavinia Stelea, Catalin Dumitru, George Noditi, Amadeus Dobrescu, Cristian Paleru, Ana-Olivia Toma
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Surgical treatment of anal fistula
A. Ya. Ilkanich, V. V. Darwin, E. A. Krasnov, F. Sh. Aliyev, K. Z. Zubailov
Сибирский научный медицинский журнал.2023; 43(5): 74. CrossRef
Evaluation of the Cutting Seton Technique in Treating High Anal Fistula
Asim M Almughamsi, Mohamed Khaled S Zaky, Abdullatif M Alshanqiti, Ibrahim S Alsaedi, Hamed I Hamed, Tariq E Alharbi, Ali A Elian
Cureus.2023;[Epub] CrossRef
Comparison of loose combined cutting seton and traditional cutting seton for high anal fistula: a meta-analysis
Yi SUN, Chunqiang WANG, Tianye HUANG, Xuebing WANG
Gazzetta Medica Italiana Archivio per le Scienze Mediche.2023;[Epub] CrossRef
Evaluating the Efficacy of Cutting Setons for the Treatment of Anal Fistulas
Miguel E. Gomez, Koianka Trencheva, Matthew Symer, Kelly Garrett, Jeffrey W. Milsom, Parul J. Shukla
Indian Journal of Surgery.2022; 84(5): 961. CrossRef
Advancing standard techniques for treatment of perianal fistula; when tissue engineering meets seton
Hojjatollah Nazari, Zahra Ebrahim Soltani, Reza Akbari Asbagh, Amirsina Sharifi, Abolfazl Badripour, Asieh Heirani Tabasi, Majid Ebrahimi Warkiani, Mohammad Reza Keramati, Behnam Behboodi, Mohammad Sadegh Fazeli, Amir Keshvari, Mojgan Rahimi, Seyed Mohsen
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Treatment of the fistula tract with laser ablation in high anal fistula
Erkan Karacan, Eyüp Murat Yılmaz
Journal of Clinical Medicine of Kazakhstan.2022; 19(6): 43. CrossRef
Influence of the cotton and silastic seton on the distance of the anal sphincter cables after fistulotomy in rats
Ana Laura Sanches Lima, Beatriz Schorro Gianini, Bruna Miranda Santana, Carlos Henrique Marques dos Santos, Doroty Mesquita Dourado, Juliano Seger Falcão, Lucas Bannwart, Sara Jéssica Falcão Câmara
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Outcome of Colorectal Surgery in Elderly Populations: Mostafa Shalaby, Nicola Di Lorenzo, Luana Franceschilli, Federico Perrone, Giulio P. Angelucci, Silvia Quareisma, Achille L. Gaspari, Pierpaolo Sileri; Ann Coloproctol. 2016;32(4):139-143. Published online August 31, 2016; DOI: https://doi.org/10.3393/ac.2016.32.4.139

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14 Citations

Abstract PDF

Purpose

The aim of this study is to investigate the impact of age on short-term outcomes after colorectal surgery in terms of the 30-day postoperative morbidity and mortality rates.

Methods

The subjects for the study were patients who had undergone colorectal surgery. Patients were divided into 2 groups according to age; groups A and B patients were ≥80 and <80 years old of age, respectively. Both groups were manually matched for body mass index, American Society of Anesthesiologists score, Charlson Comorbidity Index and procedure performed.

Results

A total of 200 patients, 91 men (45.5%) and 109 women (54.5%), were included in this retrospective study. These patients were equally divided into 2 groups. The mean ages were 85 years in group A (range, 80 to 104 years) and 55.3 years in group B (range, 13 to 79 years). The overall 30-day postoperative mortality rate was 1% of total 200 patients; both of these 2 patients were in group A. However, this observation had no statistical significance. No intraoperative complications were encountered in either group. The overall 30-day postoperative morbidity rate was 27% (54 of 200) for both groups. The 30-day postoperative morbidity rates in groups A and B were 28% (28 of 100) and 26% (26 of 100), respectively. However, these differences between the groups had no statistical significance importance.

Conclusion

Age alone should not be considered to be more of a contraindication or a worse predictor than other factors for the outcome after colorectal surgery on elderly patients.

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International Journal of Environmental Research and Public Health.2022; 19(22): 15299. CrossRef
Perioperative score for octogenarian patients eligible for rectal cancer surgery
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G. Giarratano, M. Shalaby, C. Toscana, P. Sileri
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Xiaohong Zhao, Yunmei Yang, Haifeng Gu, Wenjing Zhou, Qin Zhang
Journal of Geriatric Oncology.2020; 11(8): 1250. CrossRef
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Hülya Sarikaya, Tahar Benhidjeb, Sergiu I. Iosivan, Theodoros Kolokotronis, Christine Förster, Stephan Eckert, Ludwig Wilkens, Alaa Nasser, Sebastian Rehberg, Martin Krüger, Jan Schulte am Esch
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Isaac Seow-En, Winson Jianhong Tan, Sreemanee Raaj Dorajoo, Sharon Hui Ling Soh, Yi Chye Law, Soo Yeun Park, Gyu-Seok Choi, Wah Siew Tan, Choong Leong Tang, Min Hoe Chew
World Journal of Gastrointestinal Surgery.2019; 11(5): 247. CrossRef
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Evan Lapinsky, Lillian C. Man, Amy R. MacKenzie
Current Oncology Reports.2019;[Epub] CrossRef
Evaluation of short-term outcomes of laparoscopic-assisted surgery for colorectal cancer in elderly patients aged over 75 years old: a multi-institutional study (YSURG1401)
Keisuke Kazama, Toru Aoyama, Tsutomu Hayashi, Takanobu Yamada, Masakatsu Numata, Shinya Amano, Mariko Kamiya, Tsutomu Sato, Takaki Yoshikawa, Manabu Shiozawa, Takashi Oshima, Norio Yukawa, Yasushi Rino, Munetaka Masuda
BMC Surgery.2017;[Epub] CrossRef
Colorectal Surgery in Elderly Patients
Byung Chun Kim
Annals of Coloproctology.2016; 32(4): 126. CrossRef

Age Over 80 is a Possible Risk Factor for Postoperative Morbidity After a Laparoscopic Resection of Colorectal Cancer: Taekhyun Kang, Hyung Ook Kim, Hungdai Kim, Ho-Kyung Chun, Won Kon Han, Kyung Uk Jung; Ann Coloproctol. 2015;31(6):228-234. Published online December 31, 2015; DOI: https://doi.org/10.3393/ac.2015.31.6.228

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Abstract PDF

Purpose

With extended life expectancy, the mean age of patients at the time of diagnosis of colorectal cancer and its treatment, including radical resection, is increasing gradually. We aimed to evaluate the impact of age on postoperative clinical outcomes after a laparoscopic resection of colorectal cancers.

Methods

This is a retrospective review of prospectively collected data. Patients with primary colorectal malignancies or premalignant lesions who underwent laparoscopic colectomies between January 2009 and April 2013 were identified. Patients were divided into 6 groups by age using 70, 75, and 80 years as cutoffs: younger than 70, 70 or older, younger than 75, 75 or older, younger than 80, and 80 or older. Demographics, pathological parameters, and postoperative clinical outcomes, including postoperative morbidity, were compared between the younger and the older age groups.

Results

All 578 patients underwent a laparoscopic colorectal resection. The overall postoperative complication rate was 21.1% (n = 122). There were 4 cases of operative mortality (0.7%). Postoperative complication rates were consistently higher in the older groups at all three cutoffs; however, only the comparison with a cutoff at 80 years showed a statistically significant difference between the younger and the older groups.

Conclusion

Age over 80 is a possible risk factor for postoperative morbidity after a laparoscopic resection of colorectal cancer.

Citations

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Octogenarian patients with colon cancer – postoperative morbidity and mortality are the major challenges
Øystein Høydahl, Tom-Harald Edna, Athanasios Xanthoulis, Stian Lydersen, Birger Henning Endreseth
BMC Cancer.2022;[Epub] CrossRef
Differential short-term outcomes of laparoscopic resection in colon and rectal cancer patients aged 80 and older: an analysis of Nationwide Inpatient Sample
Kuan-Chih Chung, Ko-Chao Lee, Hong-Hwa Chen, Kung-Chuan Cheng, Kuen-Lin Wu, Ling-Chiao Song
Surgical Endoscopy.2021; 35(2): 872. CrossRef
Age and comorbidities do not affect short-term outcomes after laparoscopic rectal cancer resection in elderly patients. A multi-institutional cohort study in 287 patients
Roberto Peltrini, Nicola Imperatore, Filippo Carannante, Diego Cuccurullo, Gabriella Teresa Capolupo, Umberto Bracale, Marco Caricato, Francesco Corcione
Updates in Surgery.2021; 73(2): 527. CrossRef
Short-term and long-term outcomes after laparoscopic surgery for elderly patients with colorectal cancer aged over 80 years: a propensity score matching analysis
Masako Utsumi, Takeru Matsuda, Kimihiro Yamashita, Hiroshi Hasegawa, Kyosuke Agawa, Naoki Urakawa, Shingo Kanaji, Taro Oshikiri, Tetsu Nakamura, Yoshihiro Kakeji
International Journal of Colorectal Disease.2021; 36(11): 2519. CrossRef
Type and Consequences of Short-Term Complications in Colon Cancer Surgery, Focusing on the Oldest Old
Marisa Baré, Laura Mora, Miguel Pera, Pablo Collera, Maximino Redondo, Antonio Escobar, Rocío Anula, José María Quintana, M. Redondo, F. Rivas, E. Briones, E. Campano, A.I. Sotelo, F. Medina, A. Del Rey, M.M. Morales, S. Gómez, M. Baré, M. Pont, N. Torà,
Clinical Colorectal Cancer.2020; 19(1): e18. CrossRef
Short-term outcomes of laparoscopic surgery for colorectal cancer in the elderly versus non-elderly: a systematic review and meta-analysis
Nobuaki Hoshino, Yudai Fukui, Koya Hida, Yoshiharu Sakai
International Journal of Colorectal Disease.2019; 34(3): 377. CrossRef
Safety and Prognosis of Transarterial Chemoembolization for Octogenarians with Hepatocellular Carcinoma
Hua-Ming Cheng, Toshihiro Tanaka, Hideyuki Nishiofuku, Yuto Chanoki, Katsutoshi Horiuchi, Tetsuya Masada, Shota Tatsumoto, Takeshi Matsumoto, Nagaaki Marugami, Kimihiko Kichikawa
CardioVascular and Interventional Radiology.2019; 42(10): 1413. CrossRef
Minimally invasive surgery for colorectal cancer in advanced age patients
Z. B. Khalilov, A. Yu. Kalinichenko, R. Kh. Azimov, M. A. Chinikov, I. S. Panteleeva, F. S. Kurbanov
Khirurgiya. Zhurnal im. N.I. Pirogova.2018; (3): 76. CrossRef
Efficacy of video-assisted procedures in advanced age patients with colorectal cancer
Z. B. Khalilov, A. Yu. Kalinichenko, R. Kh. Azimov, I. S. Panteleeva, M. A. Chinikov, F. S. Kurbanov
Khirurgiya. Zhurnal im. N.I. Pirogova.2018; (2): 74. CrossRef
Cost-effectiveness of colorectal cancer screening and treatment methods: Mapping of systematic reviews
Hossein M Abdolahi, Ali S Asiabar, Saber Azami-Aghdash, Fatemeh Pournaghi-Azar, Aziz Rezapour
Asia-Pacific Journal of Oncology Nursing.2018; 5(1): 57. CrossRef
Laparoscopic surgery for colon cancer in elderly patients
Z. B. Khalilov, A. Yu. Kalinichenko
Khirurgiya. Zhurnal im. N.I. Pirogova.2017; (3): 86. CrossRef
Evaluation of safety, feasibility and the long-term outcomes of colorectomy for colorectal adenocarcinoma in patients older than 80 years of age
Norio Yukawa, Toru Aoyama, Tsutomu Sato, Takashi Oshima, Takaki Yoshikawa, Yasushi Rino, Munetaka Masuda
Molecular and Clinical Oncology.2017; 7(4): 564. CrossRef
Evaluation of short-term outcomes of laparoscopic-assisted surgery for colorectal cancer in elderly patients aged over 75 years old: a multi-institutional study (YSURG1401)
Keisuke Kazama, Toru Aoyama, Tsutomu Hayashi, Takanobu Yamada, Masakatsu Numata, Shinya Amano, Mariko Kamiya, Tsutomu Sato, Takaki Yoshikawa, Manabu Shiozawa, Takashi Oshima, Norio Yukawa, Yasushi Rino, Munetaka Masuda
BMC Surgery.2017;[Epub] CrossRef
The possibility of endovideosurgical interventions for the treatment of the older-age patients presenting with rectal cancer
Z. B. Khalilov, R. H. Azimov, M. A. Chinikov, I. S. Panteleeva, F. S. Kurbanov
Dokazatel'naya gastroenterologiya.2017; 6(4): 53. CrossRef
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Catalina Mosquera, Konstantinos Spaniolas, Timothy L Fitzgerald
World Journal of Gastroenterology.2016; 22(43): 9544. CrossRef
Colorectal Surgery in Elderly Patients
Byung Chun Kim
Annals of Coloproctology.2016; 32(4): 126. CrossRef
Impact of octogenarians on surgical outcome in colorectal cancer
Basilio Pirrera, Samuele Vaccari, Dajana Cuicchi, Ferdinando Lecce, Emilio De Raffele, Barbara Dalla Via, Marco Di Laudo, Valeria Tonini, Maurizio Cervellera, Bruno Cola
International Journal of Surgery.2016; 35: 28. CrossRef

Delorme's Procedure: An Effective Treatment for a Full-Thickness Rectal Prolapse in Young Patients: Mohammad Sadegh Fazeli, Ali Reza Kazemeini, Amir Keshvari, Mohammad Reza Keramati; Ann Coloproctol. 2013;29(2):60-65. Published online April 30, 2013; DOI: https://doi.org/10.3393/ac.2013.29.2.60

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Abstract PDF

Purpose

Delorme's procedure is infrequently applied in young adults because of its assumed higher recurrence rate. The aim of this prospective study was to assess the efficacy of the Delorme's technique in younger adults.

Methods

Fifty-two consecutive patients were entered in our study. We followed patients for at least 30 months. Their complaints and clinical exam results were noted.

Results

Our study included 52 patients (mean age, 38.44 years; standard deviation, 13.7 years). Of the included patients, 41 (78.8%) were younger than 50 years of age, and 11 (21.1%) were older than 50 years of age. No postoperative mortalities or major complications were noted. Minor complications were seen in 5 patients (9.6%) after surgery. The mean hospital stay was 2.5 days. In the younger group (age ≤50 years), fecal incontinence was improved in 92.3% (12 out of 13 with previous incontinence) of the patients, and recurrence was seen in 9.75% (4 patients). In the older group (age >50 years), fecal incontinence was improved in 20% (1 out of 5 with previous incontinence) of the patients, and recurrence was seen in 18.2% (2 patients). In 50% of the patients with a previous recurrence (3 out of 6 patients) following Delorme's procedure as a secondary procedure, recurrence was observed.

Conclusion

Delorme's procedure, especially in younger patients, is a relatively safe and effective treatment and should not be restricted to older frail patients. This procedure may not be suitable for recurrent cases.

Citations

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Henry H. Chill, Alireza Hadizadeh, Angela Leffelman, Claudia Paya Ten, Cecilia Chang, Roger P. Goldberg, Ghazaleh Rostaminia
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Henry H. Chill, Sonia Gilani, Alireza Hadizadeh, Cecilia Chang, Nani P. Moss, Roger P. Goldberg, Ghazaleh Rostaminia
European Journal of Obstetrics & Gynecology and Reproductive Biology.2025; 312: 114512. CrossRef
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Alessandro Sturiale, Lisa Fralleone, Bernardina Fabiani, Claudia Menconi, Vittorio d'Adamo, Gabriele Naldini
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Delorme's procedure for urgent rectal prolapse – A video vignette
A. Teresa Calderón Duque, Esther María Cano Pecharromán, Javier Broekhuizen Benítez, Laura Arriero Ollero, Lourdes Gómez Ruiz, Tomas Balsa Marín
Colorectal Disease.2023; 25(3): 513. CrossRef
External rectal prolapse: more than meets the eye
M. Yiasemidou, C. Yates, E. Cooper, R. Goldacre, I. Lindsey
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Delorme’s vs. Altemeier’s in the management of rectal procidentia: systematic review and meta-analysis
Pratik Bhattacharya, Mohammad Iqbal Hussain, Shafquat Zaman, Sophie Randle, Yousaf Tanveer, Nameer Faiz, Diwakar Ryali Sarma, Rajeev Peravali
Langenbeck's Archives of Surgery.2023;[Epub] CrossRef
What are the surgical options for recurrent rectal prolapse – retrospective single-center experience
Tomasz Kościński, Krzysztof Szmyt
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Trends in the surgical management of rectal prolapse: An Asian experience
Yvonne Ying‐Ru Ng, Emile John Kwong Wei Tan, Cherylin Wan Pei Fu
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Longer prolapsed rectum length increases recurrence risk after Delorme’s procedure
Taro Tanabe, Emi Yamaguchi, Takuya Nakada, Risa Nishio, Kinya Okamoto, Tetsuo Yamana
Annals of Coloproctology.2022; 38(4): 314. CrossRef
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Przemysław Ciesielski, Magdalena Szczotko, Małgorzata Kołodziejczak
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Eloy Maldonado Marcos, Pere Planellas Giné, Júlia Gil Garcia, Ramon Farrés Coll, Antoni Codina Cazador
Cirugía Española.2021; 99(5): 389. CrossRef
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Eloy Maldonado Marcos, Pere Planellas Giné, Júlia Gil Garcia, Ramon Farrés Coll, Antoni Codina Cazador
Cirugía Española (English Edition).2021; 99(5): 389. CrossRef
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S. H. Emile, H. Elbanna, M. Youssef, W. Thabet, W. Omar, A. Elshobaky, T. M. Abd El‐Hamed, M. Farid
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Clinical Characteristics and Surgical Safety in Patients with Acute Appendicitis Aged over 80: Kwon Sang Moon, Yong Hwan Jung, Eun Hun Lee, Yong Hee Hwang; J Korean Soc Coloproctol. 2012;28(2):94-99. Published online April 30, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.2.94

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Abstract PDF

Purpose

The aim of this study was to evaluate the clinical characteristics and treatment outcomes, including surgical safety, in patients over 80 years of age who underwent an appendectomy.

Methods

This study involved 160 elderly patients who underwent an appendectomy for acute appendicitis: 28 patients over 80 years old and 132 patients between 65 and 79 years old.

Results

The rate of positive rebound tenderness was significantly higher in the over 80 group (P = 0.002). Comparisons of comorbidity, diagnostic tool and delay in surgical treatment between the two groups were not statistically different. American Society of Anesthesiologists score was significantly higher in the over 80 group than in the 65 to 79 group (2.4 ± 0.5 vs. 1.6 ± 0.5; P < 0.00005). Comparisons of operative times and use of drainage between the two groups were not statistically different. In the pathologic findings, periappendiceal abscess was more frequent in the over 80 group (P = 0.011). No significant differences existed between the two groups when comparing the results of gas out and the time to liquid diet, but the postoperative hospital stay was significantly longer in the over 80 group (P = 0.001). Among the postoperative complications, pulmonary complication was significantly higher in the over 80 group (P = 0.005). However, operative mortality was zero in each group.

Conclusion

In case of suspicious appendicitis in elderly patients, efforts should be made to use aggressive diagnostic intervention, do appropriate surgery and prevent pulmonary complications especially in patients over 80 years of age.

Citations

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Scheduled Surgery and Antibiotic Therapy in Catarrhal Acute Appendicitis
Rahantasoa Prudence, Rakotonaivo Judicael, Razafimandimby M., Rasoaherinomenjanahary Fanjandrainy, Samison Hervé
European Journal of Clinical and Biomedical Sciences.2024; 10(3): 38. CrossRef

Laparoscopic Versus Open Appendectomy for Appendicitis in Elderly Patients: Hyun Nam Baek, Yong Hwan Jung, Yong Hee Hwang; J Korean Soc Coloproctol. 2011;27(5):241-245. Published online October 31, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.5.241

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Abstract PDF

Purpose

The appendectomy is the most common emergent surgical procedure in elderly patients. The increasing number of elderly persons has been accompanied by an increase in the number of cases of acute appendicitis in the elderly. In order to understand the clinical significance of a laparoscopic appendectomy for elderly patients with appendicitis, we investigated the results of a laparoscopic appendectomy for treating patients over 60 years of age with appendicitis and compared them with the results for an open technique.

Methods

We studied retrospectively patients over 60 years of age who underwent an appendectomy with either a laparoscopic (LA) or open (OA) technique for appendicitis between July 2007 and December 2009. There were 30 patients in the LA group and 47 patients in the OA group. The demographic data, operative time, length of the hospital stay, bowel movement, pain control, cost, complications and pre-existing disease were assessed.

Results

There were no significant differences between the LA and the OA groups with respect to pre-existing diseases, gender, age, American Society of Anesthesiologists (ASA) score and the number of cases of complicated appendicitis, operative time, length of hospital stay, and times of analgesics use. However, the proportion of early gas out (within POD #2) was significantly greater in the LA group (80% vs. 57%, P < 0.05), and postoperative complications were significantly lower in the LA group (7% vs. 32%, P < 0.01). The costs for the two groups were not significantly different.

Conclusion

A laparoscopic appendectomy is a safe and effective procedure in elderly patients and is not associated with any increase in morbidity. It can be recommended for routine use in treating elderly patients with appendicitis.

Citations

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Therapeutic effectiveness and influencing factors of laparoscopic appendectomy with mesoappendix dissection in the treatment of acute appendicitis
Jiang Yuan, Qiang Liu, Bo-Yu Wu
World Journal of Gastrointestinal Surgery.2025;[Epub] CrossRef
EAES/SAGES evidence-based recommendations and expert consensus on optimization of perioperative care in older adults
Deborah S. Keller, Nathan Curtis, Holly Ann Burt, Carlo Alberto Ammirati, Amelia T. Collings, Hiram C. Polk, Francesco Maria Carrano, Stavros A. Antoniou, Nader Hanna, Laure-Meline Piotet, Sarah Hill, Anne C. M. Cuijpers, Patricia Tejedor, Marco Milone, E
Surgical Endoscopy.2024; 38(8): 4104. CrossRef
Laparoscopic and robotic surgery for colorectal cancer in older patients: a systematic review and meta-analysis
Carlo Alberto Ammirati, Roberto Passera, Elsa Beltrami, Chiara Peluso, Nader Francis, Alberto Arezzo
Minimally Invasive Therapy & Allied Technologies.2024; 33(5): 253. CrossRef
The Role of Basic Laboratory Parameters in Diagnosing Acute Appendicitis and Determining Disease Severity in the Elderly
Mustafa Yeni, Rıfat Peksöz
Turkish Journal of Colorectal Disease.2022; 32(2): 110. CrossRef
Comparison of Postoperative Acute Kidney Injury Between Laparoscopic and Laparotomy Procedures in Elderly Patients Undergoing Colorectal Surgery
Shun Huang, Zheng Li, Nan Zou, Ting Dai, Xiang Long Cao, Zhe Jia, Wen Ping Peng, Ning Yang, Rui Fang Jia, Ming Zhang Zuo
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2021; 31(2): 160. CrossRef
GERİATRİK AKUT APANDİSİTLERİN TANI VE TEDAVİSİNDEKİ FARKLILIKLAR: TEK MERKEZ DENEYİMİ
Ahmet TÜRKAN, Ahmet ERDOĞAN, Uğur KILINÇ
Kırıkkale Üniversitesi Tıp Fakültesi Dergisi.2021; 23(1): 1. CrossRef
Acute Appendicitis in the Elderly: A Literature Review on an Increasingly Frequent Surgical Problem
Sintija Lapsa, Arturs Ozolins, Ilze Strumfa, Janis Gardovskis
Geriatrics.2021; 6(3): 93. CrossRef
Perforated vs. nonperforated acute appendicitis: evaluation of short-term surgical outcomes in an elderly population
Fabio Rondelli, Michele De Rosa, Paolo Stella, Marcello Boni, Graziano Ceccarelli, Ruben Balzarotti, Andrea Polistena, Alessandro Sanguinetti, Walter Bugiantella, Nicola Avenia
Minerva Chirurgica.2019;[Epub] CrossRef
Outcomes of appendectomy in elderly veteran patients
Oswaldo Renteria, Zain Shahid, Sergio Huerta
Surgery.2018; 164(3): 460. CrossRef
Independent Preoperative Predictors of Prolonged Length of Stay after Laparoscopic Appendectomy in Patients over 30 Years of Age: Experience from a Single Institution
Eric S. Wise, Stephen P. Gadomski, Annette M. Ilg, Camilo Bermudez, Emily W. Chan, Michelle L. Izmaylov, Samantha J. Gridley, Jessica V. Kaczmarek, Norman T. Melancon, Sarwat Ahmad, Kyle M. Hocking, Jose J. Diaz, Stephen M. Kavic
The American Surgeon™.2016; 82(11): 1092. CrossRef
Conventional Laparoscopic Appendicectomy and Laparoscope-Assisted Appendicectomy: a Comparative Study
Mayank Baid, Manoranjan Kar, Utpal De, Mrityunjay Mukhopadhyay
Indian Journal of Surgery.2015; 77(S2): 330. CrossRef
Acute appendicitis: position paper, WSES, 2013
Ferdinando Agresta, Luca Ansaloni, Fausto Catena, Luca Andrea Verza, Daniela Prando
World Journal of Emergency Surgery.2014;[Epub] CrossRef
Thirty-day outcomes of laparoscopic versus open appendectomy in elderly using ACS/NSQIP database
Ashkan Moazzez, Rodney J. Mason, Namir Katkhouda
Surgical Endoscopy.2013; 27(4): 1061. CrossRef

The Characteristics of Colorectal Cancer in Patients Older than 80 Years.: Lee, Jae Myeong , Kim, Hee Cheol , Park, In Ja , Kim, Dae Dong , Yu, Chang Sik , Kim, Jin Cheon; J Korean Soc Coloproctol. 2007;23(6):490-496.; DOI: https://doi.org/10.3393/jksc.2007.23.6.490

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Abstract PDF

PURPOSE
The frequency of surgery for elderly Koreans with colorectal cancer has increased because of the current life expectancy rates. The purpose of this study is to identify the characteristics of colorectal cancer in very elderly patients, to determine the optimal treatment decision, and to evaluate the patients prognosis.
METHODS
Between 1989~2005, 181 patients (96 men and 85 women, median age 82) over the age of 80 with colorectal cancer underwent surgery at OO hospital, Korea. Medical records with these patients' co-morbidities, symptoms, clinico-pathologic characteristics, complications, survival, and other relevant data were obtained and analyzed retrospectively.
RESULTS
The principal clinical symptoms were bleeding (45.3%) and bowel habit change (40.9%). Of these patients, 126 had at least one preoperative co-morbidity, and hypertension (29.3%), and cardiac disease (16.0%) were common. Curative surgery was performed in 82.9% (n=150). Emergency surgery was performed in 6.1% (n=11), and the principal cause was obstruction. The most common location of the colorectal cancer was the rectum (39.8%). There were postoperative complications in 36.4% of the patients, including voiding difficulty (12.2%) and wound infection (9.9%). The thirty-day mortality rate was 0.6% (n=1). A preoperative, low PaO2 level significantly increased the incidence of postoperative complications (P=0.036). The five-year survival rate of the curative resection group was higher than that in the remaining patients (44.3% vs. 38.8%, P<0.001).
CONCLUSIONS
Although the preoperative morbidity was high in these very elderly patients, it could be lowered with strict patient management. In addition, these patients showed a relatively good survival rate. Therefore, we believe that major, curative, colorectal surgery should be performed in selected very elderly patients.

Citations

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Prediction of early postoperative desaturation in extreme older patients after spinal anesthesia for femur fracture surgery: a retrospective analysis
Youn Yi Jo, Chun Gon Park, Ji Yeon Lee, Sun Koo Kwon, Hyun Jeong Kwak
Korean Journal of Anesthesiology.2019; 72(6): 599. CrossRef
Can Elderly Patients Older than 75 Years with Colorectal Cancer Tolerate Planned Laparoscopic Surgery?
Kang San Lee, Young Wan Kim, Joo Hee Kim, Hyun Jun Kwon, Ik Yong Kim
The Journal of Minimally Invasive Surgery.2012; 15(4): 126. CrossRef
The Outcome and Propriety of Surgical Treatment of Colorectal Cancer in the Elderly
Hye-Won Hwang, Min-Young Koo, Jeong-Eun Lee, Ryung-Ah Lee, Kwang-Ho Kim
Journal of the Korean Surgical Society.2010; 78(2): 93. CrossRef

Safety of a One-stage Operation for an Obstructed Left Colon Carcinoma.: Oh, Soo Youn , Ahn, Eun Jung , Chung, Soon Sup , Lee, Ryung Ah , Kim, Kwang Ho , Park, Eung Bum; J Korean Soc Coloproctol. 2005;21(4):207-212.

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Abstract PDF: PURPOSE
For a left-sided colonic obstruction, the traditional method of a staged defunctioning colostomy and resection has been performed. Recently, there has been a trend towards a one-stage primary resection and anastomosis. The aim of this study was to assess the safety and the efficacy of a one-stage resection and anastomosis for obstructed left colon cancer.
METHODS
We retrospectively reviewed the records of 29 patients who had been diagnosed as having an obstructed left-sided colon cancer during the period from January 1995 to December 2003 at Ewha Womans University Hospital. We compared two techniques, a one-stage operation (10 cases) and a staged operation (13 cases).
RESULTS
The mean age of the one-stage group was 58.5+/-16.1, and that of the staged operation group was 65.0+/-13.4. Both groups had similar co-morbidities, TNM stages, and tumor locations. In the one-stage operation group, a subtotal colectomy (n=3), a resection and anastomosis with intraoperative lavage (n=5), and a resection and anastomosis following stent insertion (n=2) had been performed. Patients who had undergone a colostomy as the first operation, resection and anastomosis (n=3), and a resection and anastomosis following a defunctioning colostomy (n=10) were included in the staged operation group. The mean postoperative hospital stay showed no significant differences between the two groups. One patient who had undergone a one-stage operation presented with an intestinal partial obstruction five months later. There were no anastomotic leakages, intraabdominal absceses, and wound infections, nor were there any mortalities.
CONCLUSIONS
A one-stage resection and primary anastomosis for obstructed left-sided colon cancer can be done safely without significant morbidity.

Temporary Indwelling of Self-expandable Metal Stent may Obviate the Need of Staged Operation for Malignant Colonic Obstruction.: Kim, Bong Wan , Lee, Kwang Jae , Kim, Jin Hong , Suh, Kwang Wook; J Korean Soc Coloproctol. 2001;17(2):91-96.

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Abstract PDF: PURPOSE
Staged operation employing temporary enterostomy is still the standard treatment of malignant colonic obstruction (MCO). Expandable metal stent has been used for the palliation of unresectable gastrointestinal obstruction. We applied this metal stent technique to the MCO to achieve temporary alleviation of the obstruction so that the bowel preparation and one-stage operation were enabled. In this study we examined the efficacy of temporary indwelling of metal stent to obviate the need of staged operation in the treatment of MCO.
METHODS
From December 1998 to January 2001, 35 MCO patients were treated. Patients had typical symptoms of colonic obstruction such as abdominal pain and distension. When they were admitted, an self-expandable metal stent was introduced under the guide of flexible colonoscopy. For three days, formal bowel preparation (both chemical and mechanical) were followed. With regard to achievement of bowel preparation, postoperative complications and hospital stay, these 35 patients were compared with control group (N=20) of patients who underwent two staged operations for MCO.
RESULTS
The tumor locations were upper rectum (N=10), sigmoid colon (N=22) and left colon (N=3). Metal stent slipped off in one patient. Double contrast barium enema was possible in 34 patients. One stage operation was performed in all patients. Anastomotic complications were not observed in both groups. Intraabdominal abscess requiring reoperation was noted in one patient in each group. Wound infection was noted in 3 (8.6%) stent patients whereas 16 (80%) patients had wound complication in the control group (P<0.05). Mean hospital stay was 12.2 days in stent group and 29.4 days in control group (P<0.05).
CONCLUSIONS
Even though our series is limited in patient number, these data suggested that temporary indwelling of self-expandable metal stent may obviate the need of staged operation in the treatment of MCO.

Clinical Analysis of Colorectal Cancer in the Elderly.: Yoo, Kwang Real , Jeong, Yeon Jun , Kim, Jong Hun , Hwang, Yong; J Korean Soc Coloproctol. 2000;16(2):99-108.

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Abstract PDF: PURPOSE
Elderly patients of colorectal cancer compose a steadily expanding portion of the population in Korea. The decision whether or not to operate on elderly patients who have carcinoma of colon and rectum is often unduly complicated. The aim of this study is to evaluate the results of the operations for colorectal cancers in the elderly.
METHODS
This report is a retrospective clinical analysis for 365 cases of colorectal cancer who were treated surgically at the Department of surgery, Chonbuk National University Medical School from January 1994 to December 1998. To evaluate the age factor in colorectal cancer, the patients were divided into two groups: The elderly group included 79 patients who were aged > or =70 years on first presentation; The control group comprised 286 patients aged <70.
RESULTS
There is no significant difference between the two group with regard to the mode of presentation, gender, location of tumor, clinical symptom and sign, duration of symptom, coexistent disease, operation method, tumor size, histopathologic findings, the Astler-Coller classification, lymphatic and distant metastasis, perioperative complication and 5-year survival. The emergency operation is significantly higher incidence in the elderly group.
CONCLUSIONS
It is concluded that surgical resection of colorectal cancer in elderly is standard method and should not be restricted on the basis of age alone.

Comparison of One Stage Operation with Staged Operation in Malignant Obstruction of the Left Colon and Rectum.: Kim, Hyun Ho , Kim, Byung Seok , Moon, Duk Jin , Park, Ju Sup; J Korean Soc Coloproctol. 1998;14(2):189-198.

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Abstract PDF: BACKGROUND
The optimal management of malignant obstruction of the left colon and rectum is controversial.
METHODS
A retrospective study was performed of 33 patients who underwent one-stage operation(n=11), staged operation(n=20), and palliative colostomy(n=2) at Kwangju Christian Hospital between January 1992 and December 1996.
RESULTS
Eleven patients underwent one-stage operations(7 cases with anterior resection, 3 cases with left hemicolectomy, 1 case with Miles' operation). In this group, postoperative morbidity was 36.3% including 1 wound infection(9.0%), 1 anastomotic leakage (9.0%), 1 postoperative intestinal obstruction and 1 pulmonary complication, but there was no postoperative death. The average of hospital stay in this group was 18.1 days and the first day of normal diet was 6.0 days. Twenty patients underwent staged operations including 12 cases of Hartmann's procedure. In this group, postoperative morbidity was 35.0% including 3 wound infections(15.0%), 2 pulmonary complications(10.0%), 1 parastomal hernia and 1 fistula. There were two postoperative deaths as a result of sepsis. The average of hospital stay in this group was 34.9 days and the first day of normal diet was 6.8 days.
CONCLUSION
We believe that one-stage operation was of value in management of malignant obstruction of the left colon and rectum in selected patients.

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