Urological Surgery in Elderly Patients: Results and Considerations - Part I

1992 ◽  
Vol 59 (4) ◽  
pp. 27-30
Author(s):  
G. Ferro ◽  
M. Pizzarella ◽  
F. Invidiato ◽  
P. Ligato ◽  
M. Fiorello ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Average Length ◽  
Late Complications ◽  
Major Surgery ◽  
Case Histories ◽  
Younger Patients ◽  
Average Length Of Stay ◽  
Urological Surgery ◽  
Minor Surgery ◽  
Surgery In Elderly

The objective of our study is to evaluate if patients aged over 75 years show, once operated, a different state compared to younger patients. We have taken two groups of patients from our case histories: patients who underwent major surgery (with the exception of operations which are usually not performed on those over 75 years old) and patients who underwent minor surgery. This second group is made up of patients who underwent treatment for prostate hypertrophy either surgically or endoscopically. In these groups we have tried to see any differences concerning the percentage of operated patients, mortality, early and late complications and the average length of stay in hospital.

Urological Surgery in Elderly Patients: Results and Considerations - Part II

1992 ◽  
Vol 59 (4) ◽  
pp. 31-35 ◽  
Author(s):  
M. Pizzarella ◽  
G. Ferro ◽  
F. Invidiato ◽  
P. Ligato ◽  
M. Fiorello ◽  
...  
Keyword(s):  
Numerical Analysis ◽  
Cardiovascular Diseases ◽  
Elderly Patients ◽  
The Elderly ◽  
Average Life ◽  
Average Life Span ◽  
Urological Surgery ◽  
Incidence And Mortality ◽  
Age Limits ◽  
Surgery In Elderly

It is certainly true that increase of the average life span has caused a greater percentage of elderly people to visit urological departments. From April 1989 to December 1991, patients over 75 years under our observation were 10.8% of all operated patients. Only 5% of patients over 75 who needed to be operated, weren't actually operated. The numerical analysis of our experience has highlighted the fact that in patients who underwent an operation, the incidence and mortality caused by cardiovascular diseases weren't any higher than those found in other people of the same age. We are also convinced that prejudices about age limits should not prevent the elderly afflicted with a benign or malignant urological pathology from undergoing an operation.

scholarly journals The Evolution of Cardiovascular Surgery in Elderly Patient: A Review of Current Options and Outcomes

2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Francesco Nicolini ◽  
Andrea Agostinelli ◽  
Antonella Vezzani ◽  
Tullio Manca ◽  
Filippo Benassi ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Elderly Patients ◽  
Artery Bypass ◽  
Cardiac Surgical Procedures ◽  
Mitral Valve Surgery ◽  
Clinical State ◽  
Major Surgery ◽  
Average Life Expectancy ◽  
Satisfactory Outcome ◽  
Surgery In Elderly

Due to the increase in average life expectancy and the higher incidence of cardiovascular disease with advancing age, more elderly patients present for cardiac surgery nowadays. Advances in pre- and postoperative care have led to the possibility that an increasing number of elderly patients can be operated on safely and with a satisfactory outcome. Currently, coronary artery bypass surgery, aortic and mitral valve surgery, and major surgery of the aorta are performed in elderly patients. The data available show that most cardiac surgical procedures can be performed in elderly patients with a satisfactory outcome. Nevertheless, the risk for these patients is only acceptable in the absence of comorbidities. In particular, renal dysfunction, cerebrovascular disease, and poor clinical state are associated with a worse outcome in elderly patients. Careful patient selection, flawless surgery, meticulous hemostasis, perfect anesthesia, and adequate myocardial protection are basic requirements for the success of cardiac surgery in elderly patients. The care of elderly cardiac surgical patients can be improved only through the strict collaboration of geriatricians, anesthesiologists, cardiologists, and cardiac surgeons, in order to obtain a tailored treatment for each individual patient.

scholarly journals Primary Hyperparathyroidism in Older People: Surgical Treatment with Minimally Invasive Approaches and Outcome

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Chiara Dobrinja ◽  
Marta Silvestri ◽  
Nicolò de Manzini
Keyword(s):  
Primary Hyperparathyroidism ◽  
Minimally Invasive ◽  
Elderly Patients ◽  
Average Length ◽  
The Elderly ◽  
Preoperative Imaging ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Average Length Of Stay ◽  
Operative Findings

Introduction. Elderly patients with primary hyperparathyroidism (pHPT) are often not referred to surgery because of their associated comorbidities that may increase surgical risk. The aim of the study was to review indications and results of minimally invasive approach parathyroidectomy in elderly patients to evaluate its impact on outcome.Materials and Methods. All patients of 70 years of age or older undergoing minimally approach parathyroidectomy at our Department from May 2005 to May 2011 were reviewed. Data collected included patients demographic information, biochemical pathology, time elapsed from pHPT diagnosis to surgical intervention, operative findings, complications, and results of postoperative biochemical studies.Results and Discussion. 37 patients were analysed. The average length of stay was 2.8 days. 11 patients were discharged within 24 hours after their operation. Morbidity included 6 transient symptomatic postoperative hypocalcemias while one patient developed a transient laryngeal nerve palsy. Time elapsed from pHPT diagnosis to first surgical visit evidences that the elderly patients were referred after their disease had progressed.Conclusions. Our data show that minimally invasive approach to parathyroid surgery seems to be safe and curative also in elderly patients with few associated risks because of combination of modern preoperative imaging, advances in surgical technique, and advances in anesthesia care.

scholarly journals Utility of total cell-free DNA levels for surgical damage evaluation in patients with urological surgeries

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sakae Konishi ◽  
Takuma Narita ◽  
Shingo Hatakeyama ◽  
Tohru Yoneyama ◽  
Mihoko Sutoh Yoneyama ◽  
...  
Keyword(s):  
Total Cell ◽  
Secondary Outcome ◽  
Major Surgery ◽  
Cell Free Dna ◽  
Free Dna ◽  
Urological Surgery ◽  
Before And After ◽  
Minor Surgery ◽  
Multicenter Prospective Observational Study ◽  
External Trauma

AbstractThe evaluation of surgical damage is challenging because of the lack of specific biomarkers. Total cell-free DNA (cfDNA) levels have been reported to increase with external trauma and may be a biomarker for tissue damage. To investigate the utility of perioperative total cfDNA levels in evaluating surgical damage in urological surgeries. This multicenter, prospective, observational study included 196 patients scheduled for urological surgeries between September 2020 and July 2021. The primary outcome was the change in total cfDNA levels before and after urological surgery. The secondary outcome was the effect of surgical type on total cfDNA ratio before and after urological surgery. The postoperative median total cfDNA level of the 196 patients was significantly increased 2.5-fold compared to the preoperative level (185.2 ng/mL vs. 406.7 ng/mL, P < 0.001). The median total cfDNA before/after ratio was greater than four-fold for kidney transplantation, open cystectomy, and open adrenalectomy. The ratio was less than two-fold for laparoscopic adrenalectomy and robot-assisted radical prostatectomy. Major surgery showed a significant postoperative increase in total cfDNA levels, while minor surgery did not. Total cfDNA levels increased 2.5-fold after urological surgery and it can be used as an acute-phase biomarker for surgical damage.

scholarly journals Pain management after major surgery in elderly patients

BMC Surgery ◽  
2013 ◽  
Vol 13 (Suppl 1) ◽  
pp. A11
Author(s):  
Danzi Michele ◽  
Servillo Giuseppe ◽  
Pannullo Mario ◽  
Palumbo Chiara ◽  
Reggio Stefano ◽  
...  
Keyword(s):  
Pain Management ◽  
Elderly Patients ◽  
Major Surgery ◽  
Surgery In Elderly

Risk of urological surgery in elderly patients

2016 ◽  
Vol 15 (11) ◽  
pp. e1419
Author(s):  
J. Tomasek ◽  
J. Spacek ◽  
S. Vachata ◽  
L. Holub ◽  
P. Husek ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Urological Surgery ◽  
Surgery In Elderly

scholarly journals Short-term outcomes following single-port laparoscopic surgery in elderly patients with colon cancer compared with younger patients

2017 ◽  
Vol 14 (2) ◽  
pp. 1595-1601
Author(s):  
Mitsunobu Takeda ◽  
Masayoshi Tokuoka ◽  
Hajime Hirose ◽  
Yoshihito Ide ◽  
Yasuji Hashimoto ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Laparoscopic Surgery ◽  
Elderly Patients ◽  
Single Port ◽  
Short Term ◽  
Younger Patients ◽  
Surgery In Elderly

scholarly journals Characteristics of patients hospitalised in an emergency department observation unit in Japan

2018 ◽  
Vol 14 (2) ◽  
Author(s):  
Toshiya Mitsunaga ◽  
Yuhei Ohtaki ◽  
Nobuaki Kiriyama ◽  
Kei Ohtani ◽  
Wataru Yajima ◽  
...  
Keyword(s):  
Emergency Department ◽  
Elderly Patients ◽  
Emergency Departments ◽  
Average Length ◽  
Developed Countries ◽  
The United States ◽  
University Hospital ◽  
Medical Systems ◽  
Average Length Of Stay ◽  
Emergency Medical Systems

In Japan, transporting elderly patients to emergency departments has recently posed serious problems, including a longer average time from patients’ initial emergency calls to their arrival at hospitals. To manage emergency departments more efficiently, many hospitals in the United States and some other developed countries, including Japan, introduced emergency department observation units (EDOU). However, because the usefulness of EDOUs in managing elderly patients remains uncertain, we analysed data of patients admitted to a Japanese university hospital’s EDOU to gauge its efficacy. We followed 1,426 patients admitted to the hospital’s EDOU from 1 January 2011 to 31 December 2014. The average age of patients who stayed in the EDOU increased, whereas the average length of time that they spent there decreased. Although the percentage of patients older than 65 years increased slightly, from 36.42% (2011–2012) to 37.73% (2013–2014), the proportion of those patients between the two periods did not significantly change (P = .61). Moreover, their average length of stay was 2.16 ± 0.91 days, whereas patients younger than 65 years stayed for significantly less time (1.92 ± 0.82 days). By condition, approximately 36% of patients older than 65 years presented with non-neurosurgical trauma, approximately 59% presented with other forms of trauma, but proportions of both categories of trauma were significantly smaller in patients younger than 65 years (nonneurosurgical trauma, 23%; all trauma, 47%). Most elderly patients with limb trauma prepped for surgery were transferred to other hospitals after a few days. Results suggest that the EDOU at the university hospital has served to as a buffer for regional emergency medical systems in Japan, especially given the continued ageing of the Japanese population.

scholarly journals Urological surgery in elderly patients: results and complications

2015 ◽  
pp. 379 ◽  
Author(s):  
Milos Brodak ◽  
Jan Tomasek ◽  
Lukas Holub ◽  
Petr Husek ◽  
Jaroslav Pacovsky
Keyword(s):  
Elderly Patients ◽  
Urological Surgery ◽  
Surgery In Elderly

scholarly journals Clinical presentation of urolithiasis in older and younger population

2014 ◽  
Vol 86 (4) ◽  
pp. 249 ◽  
Author(s):  
Murat Dursun ◽  
Emin Ozbek ◽  
Alper Otunctemur ◽  
Suleyman Sahin ◽  
Suleyman Sami Cakir
Keyword(s):  
Heart Disease ◽  
Elderly Patients ◽  
Average Length ◽  
The Elderly ◽  
Stone Disease ◽  
Elderly Group ◽  
Ureteral Stones ◽  
Chronic Obstructive ◽  
Younger Patients ◽  
The Difference

Aim of the study: We compared stone size, localization, complaint at the time of applying, comorbidity, treatment and complications between older (60 years of age and older) and younger patients with urolithiasis (59 years of age and younger). Materials and Methods: We retrospectively reviewed the records of 950 consecutive patients who presented to our clinic and underwent surgery for urolithiasis from January 2007 to March 2012. The patients were divided into two groups: patients ≥ 60 years an patients &lt; 60 years. Results: There were 174 men and 61 women in elderly group, 528 men and 187 women in younger group. Ureteral stones were found more often in the younger group compared to elderly patients (p &lt; 0.05). Conversely, bladder stone was more frequent in the elderly group. In the elderly group comorbidities are more frequent (diabetes mellitus, hypertension, ischemic heart disease, congestive heart disease, osteoarthritis and chronic obstructive lung). Patients ≥ 60 years significantly had larger kidney and bladder stones compared the younger, but ureteral stone sizes were not statistically different between the two groups. Older patients had a higher postoperative complication rate than younger patients (16% versus 3%, p &lt; 0.05) although postoperative complications (e.g. urinary retention, cardiac dysrythmia, fever, constipation) were not serious and resolved with medical treatment. The average length of stay in hospital was longer in the elderly group, but the difference was not statistically significant. Conclusions: Elderly patients with urolithiasis usually have larger and more complex stone disease, more comorbidities and atypical presentation.

Sign in / Sign up

Export Citation Format

Share Document