Laparoscopy in elderly patients

Arch Esp Urol. 2012 Jun;65(5):550-5.
[Article in English, Spanish]

Abstract

Objectives: Aging of the current population is an evident fact, and the surgical treatment of these patients is something we find in our daily practice. In this sense, all doubts that may arise when it comes to carrying out this technique in patients with important comorbidities appear to be cleared, as even patients with prior respiratory or heart disease benefit from the laparoscopic approach.

Methods: An analysis was carried out on a total of 99 patients over 70 years of age who underwent renal laparoscopic surgery, compared, on one hand, to 173 patients under 70 years of age undergoing the same procedure, and on the other, to 95 patients over 70 years of age who underwent open surgery We collected and compared all complications described intraoperatively and in the immediate postoperative period, as well as hospital stay.

Results: Patients over 70 years of age have a greater comorbidity compared to patients under 70 (ICH 1.46 vs. 0.89 p<0.05), but there are no statistical differences in terms of intraoperative or postoperative complications, or mean hospital stay. When compared to patients over 70 years of age with a similar comorbidity who underwent classic surgery, (ICH 1.46 vs. 1.45), we found a lower rate of complications (12.2 vs. 28.4% transfusion, 1.4 vs. 4.0% fever, p<0.05) and a shorter hospital stay (4.9 vs. 7.1%p<0.002).

Conclusion: Patient age does not seem to have a determining effect on complications or on the postoperative period of kidney disease when laparoscopy is used, which is why this method of treatment seems adequate in such cases.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Comorbidity
  • Female
  • Humans
  • Hypertension / epidemiology
  • Intraoperative Complications / epidemiology
  • Intraoperative Complications / prevention & control
  • Laparoscopy* / statistics & numerical data
  • Laparotomy / statistics & numerical data
  • Length of Stay / statistics & numerical data
  • Male
  • Nephrectomy / methods
  • Nephrectomy / statistics & numerical data
  • Obesity / epidemiology
  • Pneumoperitoneum, Artificial
  • Postoperative Complications / epidemiology
  • Postoperative Complications / prevention & control
  • Retrospective Studies
  • Risk Factors
  • Urologic Surgical Procedures / methods*
  • Urologic Surgical Procedures / statistics & numerical data