Oncosurgery in older patients

Česká verzia

Authors: Martin Oliverius ^1,2; Jan Gojda ³; Jan Hajer ⁴; Pavel Souček ⁵; Jan Šturma ¹; Beatrice Mohleníková-Duchoňová ⁶; Robert Gürlich ¹
Authors place of work: Chirurgická klinika 3. LF UK a FN Královské Vinohrady, Praha ¹; Centrum kardiovaskulární a transplantační chirurgie Brno ²; Oddělení klinické fyziologie 2. interní kliniky 3. LF UK a FNKV, Praha ³; 2. interní klinika 3. LF UK a FNKV, Praha ⁴; Oddělení toxogenomiky, Státní zdravotní ústav, Praha ⁵; Onkologická klinika LF UP a FN Olomouc ⁶
Published in the journal: Čas. Lék. čes. 2020; 159: 26-30
Category: Original Article

Summary

Population aging is one of the most significant health problems of the 21^st century and has led to an increased need for surgery in elderly patients. Only chronological age should not be decisive when indicating patients for elective procedures. Other objective findings should be taken into account too. The complex geriatric examination is an optimized, detailed and accurately defined method, which leads to better postoperative outcomes in elderly patients. In everyday practice it is sufficient to evaluate the mental, physical and nutritional state of the patient.

The goal of our study was to evaluate the perioperative morbidity and mortality of elderly patients undergoing hepatopancreatobiliary procedures. In our retrospective study we evaluated prospectively collected data of patients who underwent surgical procedures between 2015 and March 2019. In total 245 patients underwent pancreatic procedures and 156 underwent hepatic procedures. Morbidity and mortality were evaluated in the first 75 postoperative days and classified according the Clavien-Dindo classification.

Our results show that when surgical procedures are correctly indicated in elderly patients, acceptable postoperative morbidity and mortality can be achieved. Since the year 2018 we have been actively using prerehabilitation in our center and it has led to improved postoperative outcomes in elderly and high-risk patients.

Keywords:

morbidity – elderly – frailty – hepatopancreatobiliary diseases – pancreatic carcinoma – liver surgery – complex geriatric assessment – pre-rehabilitation – mortality.

Zdroje

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Štítky

Addictology Allergology and clinical immunology Angiology Audiology Clinical biochemistry Dermatology & STDs Paediatric gastroenterology Paediatric surgery Paediatric cardiology Paediatric neurology Paediatric ENT Paediatric psychiatry Paediatric rheumatology Diabetology Pharmacy Vascular surgery Pain management Dental Hygienist

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