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Background  Rectal cancer surgery in the older population remains a highly controversial topic. The present study was designed to assess whether older patients had an increased risk for postoperative complications after rectal resection for malignancies.    Methods  Consecutive patients (n =627), who underwent rectal cancer resection at a single institution, were included in the study and analyzed retrospectively. Short-term complications were compared between patients ≥80 years (n =55) and <80 years (n =572). Additionally, predictive factors for postoperative complications were analyzed.    Results  The older aged group showed a significantly higher rate of co-morbidities compared to controls, in terms of cardiovascular and pulmonary diseases ( P  =0.002,  P  =0.006). In older patients, a Hartmann’s procedure and transanal endoscopic microsurgery (TEM) were performed most frequently ( P  <0.0001).  The overall complication rate was 39% (n =244) (medical: n =59 (9%), surgical: n =185 (30%)), including 24 (44%) complications in the older aged group (medical: n =6 (11%), surgical: n =18 (33%)). Notably, the incidence of surgical and medical complications showed no significant difference between patients and controls ( P  =0.58,  P  =0.69).  Neurological and cardiovascular disorders were associated with an increased risk for a eventful postoperative course in the older aged group ( P  =0.03,  P  =0.04).    Conclusions  Rectal cancer resection can be performed safely in selected older patients. Age itself should not be considered as a risk factor for postoperative complications.

Rectal cancer surgery in older people does not increase postoperative complications - a retrospective analysis