Kolorektale Resektionen: Analyse der Morbidität und Mortalität in Bezug auf das Patientenalter

The aim was to find out the differences in morbidity and mortality of octogenarians compared to younger patients following colorectal resections. A total of 258 cases in a low volume center in Lower Austria were analyzed retrospectively (2009-01-01 to 2012-12-31). The anastomotic leakage rate and 30-day mortality were determined in relation to patient age and certain risk factors. As risk factors for an anastomotic leakage we identified male gender, BMI >30, an operative time >180 minutes, resection in the middle or lower rectum and a nonelective operation. Mortality was higher in patients with an age >80 years, ASA 3+, a nonelective resection and a prolonged operative time > 180 minutes. People aged 80 or more are not a high risk group for anastomotic leakage. For patients with above-mentioned risk factors undergoing resections in the middle and lower rectum we recommend the placement of an ileo-or colostomy to reduce the risk of this complication. Low ligation of the inferior mesenteric artery («low tie») might also be helpful. As far as the mortality is concerned, elderly people are at considerable risk. Octogenarians with comorbidities have a mortality risk up to 41% in nonelective resections. A reduction of nonelective resections by preferring two-stage procedures and the early detection of colorectal cancer by national screening programs might help to reduce the mortality risk in this patient group.