Liver resection in the elderly

Fong, Yuman; Brennan, M. F.; Cohen, Alfred M.; Heffernan, Nancy; Freiman, Alvin H.; Blumgart, Leslie H.

doi:10.1111/j.1365-2168.1997.02785.x

Cited by 51 publications

(46 citation statements)

References 16 publications

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“…[8][9][10][11] Despite these advances, the outcome of emergency surgery is less than satisfactory. We found that postoperative complications and mortality in patients aged 80 years and older undergoing emergency surgery were 2.5 times higher than in those aged 65-79 years.…”

Section: Discussionmentioning

confidence: 99%

Emergency Abdominal Surgery in Patients Aged 80 Years and Older

et al. 2000

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The outcome of emergency abdominal surgery in elderly patients remains unsatisfactory. We studied factors contributing to the outcome of abdominal emergency surgery in elderly patients, particularly in those aged 80 years and older. Subjects were 61 patients aged 80 years and older (group A) and 108 patients aged from 65 to 79 years (group B) who underwent emergency abdominal surgery between 1983 and 1997. Complications were significantly higher in group A than in group B, with respiratory failure the most common postoperative complication. Mortality rate within 30 days after surgery was also higher in group A (9.8%) than in group B (3.3%). Complications and mortality did not differ significantly between those with and without preexisting concomitant disease in group A. Systemic inflammatory response syndrome (SIRS) was seen in 35 patients in group A and 50 in group B. Severe complications occurred in 62.5% of group A with preoperative SIRS. Mortality in those with SIRS was significantly higher than those without. SIRS is thus a feasible predictor of poor outcome in patients aged 80 years and older who have emergency abdominal surgery and in those aged from 65 to 79 years. Patients with SIRS should initially receive minimal treatment whenever possible, rather than be overtreated, until their conditions stabilize.

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Section: Discussionmentioning

confidence: 99%

Emergency Abdominal Surgery in Patients Aged 80 Years and Older

et al. 2000

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“…Indeed, 15.7% of the patients with poor ASA score presented with diversion related fistulas, the most frequent complications in this series and those with the most significant impact on hospital stay (29–35 additional days). This was not unexpected as the relevance of the subjective assessment by experienced anesthesiologists in the determination of perioperative risks has been repeatedly confirmed in various types of major surgical procedures such as thoracic surgery [3]and major gastrointestinal surgery [4, 5, 6]. We suggest that cystectomy patients with ASA scores of three or above should be subjected to further preoperative evaluation focusing on parameters that could be improved or corrected.…”

Section: Discussionmentioning

confidence: 99%

Complications for Radical Cystectomy

Malavaud

Vaessen²,

Mouzin³

et al. 2001

Eur Urol

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“…safe procedure even in older patients because of improved surgical techniques, better perioperative assessment, and advances in anesthesia and medical care. 14,16,17 Human organ function usually deteriorates with age, and older patients have a high incidence of comorbid illness. In addition, HCC is frequently associated with cirrhosis, which is itself a cause of high mortality and morbidity rates after hepatectomy.…”

Section: Commentsmentioning

confidence: 99%

“…We believe that this allows for more reasonable and meaningful comparisons with other previous studies. 4,5,13,14 Other modalities of HCC management, such as percutaneous ethanol injection therapy, microwave coagulation therapy, or percutaneous radiofrequency ablation, can be acceptable alternatives to hepatic resection in older people, but the best treatment for older patients remains controversial. Generally, older patients received significant fewer surgical resections than younger patients.…”

Section: Commentsmentioning

confidence: 99%