Elective Laparoscopic Surgery in elderly patients.Is it a real threat?

Arshad M Malik, Dr. Qassim University

OBJECTIVE: .To analyze the challenges and outcome of elective Laparoscopic surgery in elderly people (65 years and above) in both the sexes.

METHODS:  This is a prospective cohort study including 255 patients, 65 years or above, operated over a period of 3 years extending from July 2012 to July 2014 in a public sector university of Pakistan. Different elective laparoscopic surgical procedures were performed by the same surgeons. The various indications included gallstones, ventral hernias, appendicitis, and diagnostic laparoscopy. All patients were admitted through OPD and were thoroughly investigated and co-morbidities addressed. A thorough pre-operative anesthesia assessment was done and patients operated according to indication after taking written consent. Descriptive statistics reported as mean, percentages and standard deviations. 

RESULTS: Two hundred and fifty five patients with a mean age 0f 73.23, Std 5.380 and range 19(66-85) were included in this study. Of the total number, in 137(53.72%) patients laparoscopic cholecystectomy was performed while 87 (34.11%) patients had laparoscopic ventral hernia repair. The remaining 31(12.15%) patients had diagnostic laparoscopy due to various reasons. Of the total number, 83% of the study population had various co-morbidities making surgery challenging for the anesthetist and surgeon as well. There was an overall 3% mortality and 7% morbidity.

CONCLUSION: Despite increasing factors in geriatric population making surgery challenging, the overall results are not as bad as they are probably thought.

KEY WORDS: Laparoscopic surgery, elderly patients, co-morbidities, mortality, morbidity.

 

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