**5. Outcome after laparoscopic surgery in the older patient**

Laparoscopic surgery has been shown to reduce postoperative pain, allowing a decreased use of opioid analgesia, reducing postoperative ileus, and a reduced hospital stay [66]. In addition, laparoscopic surgery is beneficial to the older patient since it is associated with a reduced risk of cardiovascular and pulmonary complications, reduced intraoperative blood loss, and a quicker recovery of gastrointestinal function. For example, Chaudhary et al. demonstrated that elective laparoscopic surgery for colorectal cancer was associated with lower rates of pneumonia and cardiopulmonary complications when compared to open surgery [67]. Pinto et al. compared postoperative complications between groups of older patients, with similar ASA and BMI scores, having open and laparoscopic surgery. The laparotomy group had higher overall complication rates compared to the laparoscopic group (49.1 *vs.* 22.6%, p = 0.0007). The main differences were in the postoperative medical complications, with 38.8% of the laparotomy group and 21% of the laparoscopy group having medical complications (p = 0.01). Other complications, such as wound infections, anastomotic leaks, and deep vein thrombosis, were not significantly different between the two groups [68]. Stocchi et al. [69] found that the preoperative functional status of older patients following laparoscopic surgery was more frequently maintained at the time of discharge. In a randomized trial including 553 patients, Frasson et al. [66] had similarly concluded that laparoscopy should be the first choice in elderly patients operated on for CRC because it increases the preservation of functional status, allowing a higher rate of independence during the postoperative period and discharge and a faster postoperative recovery. Compared to open surgery, laparoscopic surgery is also beneficial to the older patient due to a lower inflammatory response and lower surgical stress.
