ArticleSurgical endoscopy2026
Effect of minimally invasive surgery on activities of daily living in elderly patients aged ≥ 80 years with gastrointestinal and hepatobiliary-pancreatic cancers: a propensity score-matched analysis.
Article in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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8 authors.
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Abstract
backgroundActivities of daily living (ADL) are an important outcome of surgery for elderly patients. As life expectancy increases, interest in minimally invasive surgery (MIS) is increasing. However, there is limited evidence regarding the effect of MIS on ADL, especially in the very elderly patients (≥ 80 years).
methodsA total of 1009 consecutive patients (80-99 years) undergoing elective surgery for gastrointestinal and hepatobiliary-pancreatic tumors between 2010 and 2025 were enrolled. Propensity score matching (PSM, 1:1) was performed in 869 patients after excluding those with benign tumors or missing data. A comparison was made between MIS (laparoscopic/robotic, n = 284) and open surgery (n = 284). The primary outcome was postoperative ADL decline. Severe postoperative ADL decline was defined as a decline of ≥ 30 points in the Barthel Index total score.
resultsPostoperative ADL decline was observed in 128 patients (14.7%) in the entire cohort. After PSM, postoperative ADL decline occurred in 17.3% and 19.4% of patients in the open and MIS groups, respectively (P = 0.59). Severe postoperative ADL decline was lower in the MIS than in the open groups (5.7% vs. 9.5%, P = 0.11). The 90-day readmission rate was also lower in the MIS groups (16.6% vs. 22.3%, P = 0.11). Intraoperative blood loss, ICU and hospital length of stay, and severe postoperative complications were significantly better in the MIS group. In high-risk or frail subgroups, such as those with poor performance status, care needs, and severe complications, MIS consistently demonstrated lower rates of severe postoperative ADL decline compared with open surgery.
conclusionsCompared with open surgery, MIS reduced the incidence of severe postoperative ADL decline and 90-day readmission. Subgroup analysis indicated that this trend was strongest in high-risk or frail patients. These results suggest that MIS may help maintain postoperative independence and prevent functional frailty in the very elderly patients.
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