The Impact of Minimally Invasive Surgical Techniques on Long-term Outcomes in Elderly Patients with Colorectal Cancer: A Systematic Review

Abdulrahman Manaa  Alamri; Saleh Abdullah S Al Gharzan; Abdullah Ghazy M  Alosaimi; Mohammed Ali M Alqarni; Yazeed Khalid A Moafa; Ibrahim Ali B  Sarrar; Salem Mohammed S Alyami; Abdulaziz Salaiman M  Alsaiari; Hashan Fahad H  Alyami; Alhassan Abdullah B Almakrami

doi:10.54293/smhj.v5i2.146

Authors

Abdulrahman Manaa Alamri Associate Professor of Surgery, Department of Surgery, Medical College, Najran University, KSA.
Saleh Abdullah S Al Gharzan Medical student, Najran University, Najran, KSA.
Abdullah Ghazy M Alosaimi Medical student, Najran University, Najran, KSA.
Mohammed Ali M Alqarni Medical student, Najran University, Najran, KSA.
Yazeed Khalid A Moafa Medical student, Najran University, Najran, KSA.
Ibrahim Ali B Sarrar Medical student, Najran University, Najran, KSA.
Salem Mohammed S Alyami Medical student, Najran University, Najran, KSA. https://orcid.org/0009-0009-8185-190X
Abdulaziz Salaiman M Alsaiari Medical student, Najran University, Najran, KSA.
Hashan Fahad H Alyami Medical student, Najran University, Najran, KSA.
Alhassan Abdullah B Almakrami Medical student, Najran University, Najran, KSA. https://orcid.org/0009-0009-0390-2337

DOI:

https://doi.org/10.54293/smhj.v5i2.146

Keywords:

Minimally invasive surgeries; Laparoscopic surgery; TaTME; Colorectal cancer; Elderly; Systematic review

Abstract

The study aimed to assess the long-term impact of minimally invasive surgical (MIS) techniques on elderly patients with colorectal cancer (CRC). A search across four databases identified 898 relevant publications, with 407 of which were reviewed. Five studies included 1743 patients, with 58.1% being males. Results showed that 3-year overall survival rates varied from 60.3% in laparoscopic surgery patients to 88.9% in transanal total mesorectal excision (TaTME) patients. Local recurrence-free survival ranged from 75% to 88.1%. Elderly patients had worse outcomes, with higher local recurrence rates and shorter OS and LRFS compared to non-EP patients. Laparoscopic surgery showed comparable five-year survival outcomes to open colectomy, indicating its viability as an alternative. Studies on TaTME demonstrated favorable long-term outcomes, with low recurrence rates and improved surgical feasibility in low rectal cancer. In patients aged 80 and older, laparoscopic surgery was associated with lower 90-day mortality, reduced hospital stays, and better survival outcomes compared to open surgery.