Principles of Cancer Surgery in Older Adults

The elderly population has recorded an unprecedented growth over the last 20 years. Despite the evidence that cancer is a disease of the elderly, very little level 1 evidence on its treatment comes from current scientific literature, since patients older than 70 are often excluded from clinical randomized trials. In addition, information obtained from the methodologically well-designed studies does not always apply to elderly patients. Unfortunately, this may also translate in substandard cancer care delivered to this group as recently flagged by EUROCARE-5, the widest collaborative research project on cancer survival in Europe. The same scenario has been reported by the National Cancer Intelligence Network showing how in the UK elderly patients affected by solid tumor receive less surgery as compared to the younger counterpart. The difficulty in applying the “standard of care” more broadly needs to be searched in a combination of patients’ comorbidities, psychosocial issues, and physicians’ attitude. All these factors contribute to the challenge in the perioperative decision-making, eventually affecting the treatment outcomes. © Springer Nature Switzerland AG 2020

Anastomotic leak after manual circular stapled left-sided bowel surgery: analysis of technology-, disease-, and patient-related factors /

Anastomotic leak rates after colorectal surgery remain high. In most left-sided colon and rectal resection surgeries, a circular stapler is utilized to create the primary bowel anastomosis. However, it remains unclear whether a relationship between circular stapler technology and anastomotic leak in left-sided colorectal surgery exists