Early Outcomes of Laparoscopic Colectomy for Colon Cancer in Elderly Patients

Abstract

Author(s): Van Thoi Dang* and Thanh Hung Nguyen

Background: Colon cancer occurs predominantly in older adults, and the perioperative management of elderly patients remains challenging because of comorbidities, frailty, and reduced physiological reserve. Laparoscopic colectomy may offer short-term benefits in this population, but evidence from Vietnam remains limited. Methods: This single-center cross-sectional study included consecutive patients aged 70 years or older who underwent laparoscopic colectomy for colon cancer at Da Nang Oncology Hospital between January 2023 and January 2025. Eligible patients had postoperative histopathological confirmation of malignancy. Demographic characteristics, preoperative findings, operative details, pathological features, postoperative recovery, and 30-day complications were analyzed. Results: Thirty-four patients were included, with a mean age of 74.76 ± 5.44 years, and 58.8% were male. Abdominal pain was the most common presenting symptom (91.2%), and the sigmoid colon was the most frequent tumor location (38.2% on colonoscopy; 35.3% intraoperatively). Curative-intent surgery was performed in 33 patients (97.1%). Mean operative time was 169.26 ± 34.38 min. The mean time to first flatus was 3.38 ± 0.82 days, and mean postoperative hospital stay was 7.97 ± 1.62 days. Conventional adenocarcinoma was identified in 97.1% of cases. Pathological T3?T4 disease was present in 85.3%, nodal metastasis in 64.7%, and distant metastasis in 2.9%. Postoperative complications occurred in 23.5% of patients; most commonly wound infection (11.8%) and pneumonia (8.8%). No anastomotic leak or 30-day mortality was observed. Conclusion: Laparoscopic colectomy appears to be a feasible and safe option for selected elderly patients with colon cancer, with acceptable operative time, satisfactory postoperative recovery, and low early mortality.

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