Laparoscopic Colectomy in the Elderly: Is There a Benefit?

The role of laparoscopic surgery has gained widespread acceptance as a feasible and safe option in the management of many benign colorectal diseases. Short-term benefits such as earlier return of bowel function, less postoperative pain, and shorter length of hospital stay have been demonstrated for laparoscopic-assisted colectomy (LAC). This has been accomplished with no significant difference in morbidity and mortality when compared with open colorectal surgery. The role of laparoscopy for malignant disease remains unclear as we await the results of the COST trial. To date there is little literature regarding the impact of LAC in the elderly population (ie, patients over the age of 70 years) as the vast majority of studies regarding laparoscopic colectomy have evaluated younger patients (less than 65 years). It is unknown if elderly patients garner the same benefits from LAC that younger patients have been shown to receive. As a result, there has been reluctance to offer laparoscopy to elderly patients. This is a review of the literature examining the positives and negatives of LAC in patients >70 years of age.