Confusion in the Elderly After Colon Surgery

Study Overview
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Brief Summary
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A study will be conducted to determine if there is any cognitive benefit in elderly patients having open versus minimally invasive colon cancer surgery.

Detailed Description
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Cognitive changes in the elderly are common after surgery. It is not known if minimally invasive or laparoscopic surgery can prevent these changes. A study will be conducted on patients scheduled to have abdominal surgery. The patients will have cognitive evaluations before and after surgery. A small amount of blood, about 2 tablespoons, will be collected no more than 5 times in 6 months. The results will be analyzed to determine if there are changes between those having open surgery versus patients having laparoscopic or minimally invasive surgery, and if these changes coincide with cognitive changes.

Official Title
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Cognitive Changes After Surgery in the Elderly: Does Minimally Invasive Surgery Influence the Incidence of Postoperative Cognitive Changes Compared to Open Colon Surgery?

Conditions
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Confusion, Inflammation, Acute Phase Reaction, Surgery, Delirium

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients over age 65.0 years and in need of elective colon resection for adenocarcinoma Exclusion Criteria: Inability to complete preoperative cognitive screening Inability to complete study in English since CANTAB is timed and not validated with interpreters Emergency surgery Depression or psychiatric comorbidity Pre-existing dementia Previous cerebrovascular accident or stroke Previous myocardial infarction Cardiac ejection fraction below 55% Propranolol, metoprolol or other betablocker use Digoxin, procainamide, or amiodarone use Calcium channel blocker use History of vascular surgery or arterial vascular disease History of alcohol dependence Lovastatin or other HMG-CoA reductase inhibitor use Ace inhibitor use Neuroendocrine or catecholamine associated tumors Hypertension Diabetes Benzodiazepine use Dimenhydrinate or other medications to treat motion sickness Metaclopramide use

Ages Eligible for Study
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Minimum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Laparoscopic colon surgery<br>Patients over age 65 having laparoscopic colon resection for colonic adenocarcinoma | |
| Open colon surgery<br>Patients over age 65 having open colon resection for colonic adenocarcinoma | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Confusion | Confusion assessed by questionaires and cognitive testing | 6 Months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| degree of inflammation | 5 separate blood draws | 6 Months | 
| presence of electrolyte imbalance | 5 separate blood draws | 6 months | 
| pituitary-thyroid axis disruption | 5 separate blood draws | 6 months | 
| liver function tests | 5 separate blood draws | 6 months | 
| nutritional status | 5 separate blood draws | 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Laparoscopy, Surgery, Acute Phase Reaction, Aged, Aged 80 and over, Confusion, Inflammation, Delirium