Introduction & Objectives

Laparoscopic surgery has become the standard of care for localised renal malignancies. The efficacy and outcome of laparoscopy procedure have been established in the general population. Nonetheless, the same conclusion cannot be extrapolated to the elderly population. The objectives of this study is to compare the perioperative and oncological outcomes between elderly (>80 years old) patients undergoing laparoscopic surgery, with those patients younger than 80 years old.

Methods

This is an 11 year retrospective study involving all laparoscopic renal surgery performed by the same group of surgeons across the public and private sectors from 2001 to 2011 in Geelong, Victoria. This study is divided into two groups; 1) elderly patients (80 years old and greater) and 2) non-elderly (<80 years old) at time of operation and analyzing perioperative outcome using Clavien classification of surgical complications and oncological outcome by survival and disease-free status post-surgery.

Results

There are 170 patients in this study (19 elderly patients and 151 non-elderly patients). Using the Clavien score nominated for each complication, the severity of complication is lower in the elderly group while operation time but estimated blood loss did not show significant difference between both groups.

The elderly group had 16 had malignant histology while three cases (21.4%) were benign. There are 132 patients in the non-elderly group had cancer, 17 benign lesions(16.34%) and 2 missing data. There was 1 death in the elderly group compared to 12 deaths and 6 cases of metastasis in the non-elderly group.

Conclusion

Despite the elderly group had higher ASA score, there is no significant difference in perioperative complications from the study. Therefore, it is safe to offer laparoscopic surgery for elderly patients with renal tumour. There is good oncological outcome but unable to prove statistically due to small sample study.