We read with interest the article by Landi et al. comparing the outcome of laparoscopic and open surgery in the resection of primary rectal cancer in octogenarians and younger patients. This retrospective study of 408 patients included 52 in the laparoscopic and 53 in the open surgery groups who were aged over 80 years. The authors conclude the advantages of laparoscopic surgery appear to be lost in the over 80s, observing a significantly higher rate of medical complications. This article is protected by copyright. All rights reserved.Accepted manuscript - 12 month embargo