Pulmonary complications after surgery for rectal cancer in elderly patients: Evaluation of laparoscopic versus open approach from a multicenter study on 477 consecutive cases

Aim: To evaluate the impact of open or laparoscopic rectal surgery on pulmonary complications in elderly (>75 years old) patients. Methods: Data from consecutive patients who underwent elective laparoscopic or open rectal surgery for cancer were collected prospectively from 3 institutions. Pulmonary complications were defined according to the ACS/NSQUIP definition. Results: A total of 477 patients (laparoscopic group: 242, open group: 235) were included in the analysis. Postoperative pulmonary complications were significantly more common after open surgery (8 out of 242 patients (3.3%) versus 23 out of 235 patients (9.8%); p = 0.005). In addition, PPC occurrence was associated with the increasing of postoperative pain (5.04 ±1.62 versus 5.03 ± 1.58; p = 0.001) and the increasing of operative time (270.06 ±51.49 versus 237.37 ± 65.97; p = 0.001). Conclusion: Our results are encouraging to consider laparoscopic surgery a safety and effective way to treat rectal cancer in elderly patients, highlighting that laparoscopic surgery reduces the occurrence of postoperative pulmonary complications.