Is laparoscopic Colorectal Surgery Beneficial for Elderly Patients? A Systematic Review and Meta-Analysis

Background: Elderly patients who undergo major abdominal surgery are potentially at a higher risk of perioperative mortality and postoperative complications. Although laparoscopic surgery has been widely accepted as a less invasive surgical procedure for colorectal diseases, the benefits for elderly patients have not been validated. Aim: To compare postoperative outcomes and long-term survival between laparoscopic and open colorectal surgery in the elderly population. Methods: A literature search was electronically performed to identify all studies comparing postoperative outcomes between laparoscopic and open colorectal resections in the elderly population. Primary outcomes were postoperative mortality and complications, and the secondary outcome was long-term survival. Results: Overall, 30 studies (70,946 patients) met our inclusion criteria. Laparoscopic surgery was significantly associated with a decreased risk of perioperative mortality [odds ratio (OR), 0.55; 95 % confidence interval (CI), 0.45–0.68; P < 0.01] and postoperative complications (OR, 0.55; 95 % CI, 0.48–0.63; P < 0.01) compared with open surgery. There was no significant difference in long-term survival between the two procedures (OR, 0.89; 95 % CI, 0.72–1.07; P = 0.31). Conclusions: Laparoscopic colorectal surgery in the elderly population has significant advantages in terms of short-term outcomes. Aggressive application of laparoscopic colorectal surgery should be considered for the elderly population.