Safety of robotic general surgery in elderly patients

被引:20
作者
Buchs N.C. [1 ]
Addeo P. [1 ]
Bianco F.M. [1 ]
Ayloo S. [1 ]
Elli E.F. [1 ]
Giulianotti P.C. [1 ,2 ]
机构
[1] Division of General, Minimally Invasive and Robotic Surgery, Department of Surgery, University of Illinois at Chicago, Chicago, IL
[2] Lloyd M. Nyhus Professor of Surgery, Chief Division of General, Minimally Invasive and Robotic Surgery, University of Illinois at Chicago, Chicago, IL 60612, 840 S. Wood Street
关键词
Complications; Elderly; Liver resection; Outcomes; Pancreatic surgery; Robotic surgery;
D O I
10.1007/s11701-010-0191-1
中图分类号
学科分类号
摘要
As the life expectancy of people in Western countries continues to rise, so too does the number of elderly patients. In parallel, robotic surgery continues to gain increasing acceptance, allowing for more complex operations to be performed by minimally invasive approach and extending indications for surgery to this population. The aim of this study is to assess the safety of robotic general surgery in patients 70 years and older. From April 2007 to December 2009, patients 70 years and older, who underwent various robotic procedures at our institution, were stratified into three categories of surgical complexity (low, intermediate, and high). There were 73 patients, including 39 women (53.4%) and 34 men (46.6%). The median age was 75 years (range 70-88 years). There were 7, 24, and 42 patients included, respectively, in the low, intermediate, and high surgical complexity categories. Approximately 50% of patients underwent hepatic and pancreatic resections. There was no statistically significant difference between the three groups in terms of morbidity, mortality, readmission or transfusion. Mean overall operative time was 254 ± 133 min (range 15-560 min). Perioperative mortality and morbidity was 1.4% and 15.1%, respectively. Transfusion rate was 9.6%, and median length of stay was 6 days (range 0-30 days). Robotic surgery can be performed safely in the elderly population with low mortality, acceptable morbidity, and short hospital stay. Age should not be considered as a contraindication to robotic surgery even for advanced procedures. © 2010 Springer-Verlag London Ltd.
引用
收藏
页码:91 / 98
页数:7
相关论文
共 35 条
  • [1] Andereggen E., Ris F., Gervaz P., Bucher P., Morel P., Outcome of surgery for rectal cancer in octogenarians, Swiss Med Wkly, 136, pp. 185-188, (2006)
  • [2] Etzioni D.A., Liu J.H., Maggard M.A., Ko C.Y., The aging population and its impact on the surgery workforce, Ann Surg, 238, pp. 170-177, (2003)
  • [3] Janssen-Heijnen M.L., Maas H.A., Houterman S., Lemmens V.E., Rutten H.J., Coebergh J.W., Comorbidity in older surgical cancer patients: Influence on patient care and outcome, Eur J Cancer, 43, pp. 2179-2193, (2007)
  • [4] Janssen-Heijnen M.L., Houterman S., Lemmens V.E., Louwman M.W., Maas H.A., Coebergh J.W., Prognostic impact of increasing age and co-morbidity in cancer patients: A population-based approach, Crit Rev Oncol Hematol, 55, pp. 231-240, (2005)
  • [5] Spivak H., Maele D.V., Friedman I., Nussbaum M., Colorectal surgery in octogenarians, J Am Coll Surg, 183, pp. 46-50, (1996)
  • [6] Abir F., Alva S., Longo W.E., The management of rectal cancer in the elderly, Surg Oncol, 13, pp. 223-234, (2004)
  • [7] Hodul P., Tansey J., Golts E., Oh D., Pickleman J., Aranha G.V., Age is not a contraindication to pancreaticoduodenectomy, Am Surg, 67, pp. 270-275, (2001)
  • [8] Fong Y., Blumgart L.H., Fortner J.G., Brennan M.F., Pancreatic or liver resection for malignancy is safe and effective for the elderly, Ann Surg, 222, pp. 426-434, (1995)
  • [9] Makary M.A., Winter J.M., Cameron J.L., Campbell K.A., Chang D., Cunningham S.C., Riall T.S., Yeo C.J., Pancreaticoduodenectomy in the very elderly, J Gastrointest Surg, 10, pp. 347-356, (2006)
  • [10] Scurtu R., Bachellier P., Oussoultzoglou E., Rosso E., Maroni R., Jaeck D., Outcome after pancreaticoduodenectomy for cancer in elderly patients, J Gastrointest Surg, 10, pp. 813-822, (2006)