Özet:

tion. Rectal cancer is one of the most common neoplasms of the digestive tract and one of the leading oncological causes of death worldwide. The safety and feasibility of laparoscopic surgery in elderly patients over 70 years of age with comorbidities is still a debated and controversial topic. The objective of the study was to investigate the safety of using modern minimally invasive surgical techniques in elderly patients with major comorbidities, comparing its outcomes with open surgery techniques. Material and methods. We performed a retrospective study during the period 01.01.2017- 31.12.2021, in the General Surgery Clinic 1 of the Emergency Clinical County Hospital Constanta, Romania. During this period, 124 patients with different forms of rectal cancer were surgically approached in the clinic. Among them, we exclusively selected patients over 70 years old, who had at least one comorbidity at the time of admission. These patients were divided into two subgroups: an open surgery group (n=44, 67.7%) and a laparoscopic group (n=21, 32.3%). Results. The most frequent comorbidities were arterial hypertension, diabetes mellitus, anemia and obesity. Laparoscopic surgery had a longer operating time but less blood loss than the open surgery group. We did not encounter significant differences in terms of general systemic complications. Laparoscopic surgery proved its benefits with a lower rate of local complications and a faster recovery of the patients. Conclusions. Laparoscopic surgery is the most appropriate therapeutic approach of rectal cancer in the elderly patients with comorbidities. It is a safe, efficient therapeutic option, with numerous short and long-term advantages. Keywords: rectal cancer, elderly patients, laparoscopic surgery.

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