Emergency Surgery in the Elderly: Could Laparoscopy Be Useful in Frailty? A Single-Center Prospective 2-Year Follow-Up in 120 Consecutive Patients
Background: the general population is aging across the world. Therefore, even surgical interventions in the elderly—in particular those involving emergency surgical admissions—are becoming more frequent. The elderly population is often frail (in multiple physiological systems, this is often defined...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-03-01
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| Series: | Surgeries |
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| Online Access: | https://www.mdpi.com/2673-4095/2/1/11 |
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| author | Monica Zese Elena Finotti Giovanni Cestaro Fabio Cavallo Daniela Prando Tobia Gobbi Riccardo Zese Salomone Di Saverio Ferdinando Agresta |
| author_facet | Monica Zese Elena Finotti Giovanni Cestaro Fabio Cavallo Daniela Prando Tobia Gobbi Riccardo Zese Salomone Di Saverio Ferdinando Agresta |
| author_sort | Monica Zese |
| collection | DOAJ |
| description | Background: the general population is aging across the world. Therefore, even surgical interventions in the elderly—in particular those involving emergency surgical admissions—are becoming more frequent. The elderly population is often frail (in multiple physiological systems, this is often defined as age-related cumulative decline). This study involved a 2-year follow-up evaluation of frail elderly patients treated with urgent surgical intervention at Santa Maria Regina della Misericordia Hospital, General Surgery Department, in Adria (Italy). Method: a prospective, single-center, 2-year follow-up study of 120 patients >65 years old, treated at our department for surgical abdominal emergencies. We considered co-morbidities (ASA—American Society of Anesthesiologists Physical Status Classification System—score), type of surgery (laparoscopy, laparotomy or converted), frailty score, mortality, and complications at 30 days and at 2 years. Conclusions: 70 (58.4%) patients had laparoscopy, 49 (40.8) had laparotomy, and in 1 (0.8%) case, surgery was converted from laparoscopy to laparotomy. Mortality strictly depends on the type of surgery (laparotomy vs. laparoscopy), complications during recovery, and a lower Fried frailty criteria score, on average. The long-term follow-up can be a useful tool to highlight a safer surgical approach, such as laparoscopy, in frail elderly patients. We consider the laparoscopic approach feasible in emergency situations, with similar or better outcomes than laparotomy, especially in frail elderly patients. |
| first_indexed | 2024-03-10T13:14:35Z |
| format | Article |
| id | doaj.art-7bd56ba29bf64ffd84b1ff35f2bdaa22 |
| institution | Directory Open Access Journal |
| issn | 2673-4095 |
| language | English |
| last_indexed | 2024-03-10T13:14:35Z |
| publishDate | 2021-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Surgeries |
| spelling | doaj.art-7bd56ba29bf64ffd84b1ff35f2bdaa222023-11-21T10:28:34ZengMDPI AGSurgeries2673-40952021-03-012111912710.3390/surgeries2010011Emergency Surgery in the Elderly: Could Laparoscopy Be Useful in Frailty? A Single-Center Prospective 2-Year Follow-Up in 120 Consecutive PatientsMonica Zese0Elena Finotti1Giovanni Cestaro2Fabio Cavallo3Daniela Prando4Tobia Gobbi5Riccardo Zese6Salomone Di Saverio7Ferdinando Agresta8Department of General Surgery, ULSS5 Polesana del Veneto, Santa Maria della Misericordia Hospital, 45011 Adria, ItalyDepartment of General Surgery, Ospedale Civile Santi Giovanni and Paolo, 30122 Venezia, ItalyDepartment of General Surgery, ULSS5 Polesana del Veneto, Santa Maria della Misericordia Hospital, 45011 Adria, ItalyDepartment of General Surgery, ULSS5 Polesana del Veneto, Santa Maria della Misericordia Hospital, 45011 Adria, ItalyDepartment of General Surgery, ULSS5 Polesana del Veneto, Santa Maria della Misericordia Hospital, 45011 Adria, ItalyDepartment of General Surgery, ULSS5 Polesana del Veneto, Santa Maria della Misericordia Hospital, 45011 Adria, ItalyDepartment of Engineering, University of Ferrara, 44121 Ferrara, ItalyCambridge University Hospitals, Cambridge CB2 0QQ, UKDepartment of General Surgery, ULSS5 Polesana del Veneto, Santa Maria della Misericordia Hospital, 45011 Adria, ItalyBackground: the general population is aging across the world. Therefore, even surgical interventions in the elderly—in particular those involving emergency surgical admissions—are becoming more frequent. The elderly population is often frail (in multiple physiological systems, this is often defined as age-related cumulative decline). This study involved a 2-year follow-up evaluation of frail elderly patients treated with urgent surgical intervention at Santa Maria Regina della Misericordia Hospital, General Surgery Department, in Adria (Italy). Method: a prospective, single-center, 2-year follow-up study of 120 patients >65 years old, treated at our department for surgical abdominal emergencies. We considered co-morbidities (ASA—American Society of Anesthesiologists Physical Status Classification System—score), type of surgery (laparoscopy, laparotomy or converted), frailty score, mortality, and complications at 30 days and at 2 years. Conclusions: 70 (58.4%) patients had laparoscopy, 49 (40.8) had laparotomy, and in 1 (0.8%) case, surgery was converted from laparoscopy to laparotomy. Mortality strictly depends on the type of surgery (laparotomy vs. laparoscopy), complications during recovery, and a lower Fried frailty criteria score, on average. The long-term follow-up can be a useful tool to highlight a safer surgical approach, such as laparoscopy, in frail elderly patients. We consider the laparoscopic approach feasible in emergency situations, with similar or better outcomes than laparotomy, especially in frail elderly patients.https://www.mdpi.com/2673-4095/2/1/11laparoscopyurgent surgeryelderlyfrailty |
| spellingShingle | Monica Zese Elena Finotti Giovanni Cestaro Fabio Cavallo Daniela Prando Tobia Gobbi Riccardo Zese Salomone Di Saverio Ferdinando Agresta Emergency Surgery in the Elderly: Could Laparoscopy Be Useful in Frailty? A Single-Center Prospective 2-Year Follow-Up in 120 Consecutive Patients Surgeries laparoscopy urgent surgery elderly frailty |
| title | Emergency Surgery in the Elderly: Could Laparoscopy Be Useful in Frailty? A Single-Center Prospective 2-Year Follow-Up in 120 Consecutive Patients |
| title_full | Emergency Surgery in the Elderly: Could Laparoscopy Be Useful in Frailty? A Single-Center Prospective 2-Year Follow-Up in 120 Consecutive Patients |
| title_fullStr | Emergency Surgery in the Elderly: Could Laparoscopy Be Useful in Frailty? A Single-Center Prospective 2-Year Follow-Up in 120 Consecutive Patients |
| title_full_unstemmed | Emergency Surgery in the Elderly: Could Laparoscopy Be Useful in Frailty? A Single-Center Prospective 2-Year Follow-Up in 120 Consecutive Patients |
| title_short | Emergency Surgery in the Elderly: Could Laparoscopy Be Useful in Frailty? A Single-Center Prospective 2-Year Follow-Up in 120 Consecutive Patients |
| title_sort | emergency surgery in the elderly could laparoscopy be useful in frailty a single center prospective 2 year follow up in 120 consecutive patients |
| topic | laparoscopy urgent surgery elderly frailty |
| url | https://www.mdpi.com/2673-4095/2/1/11 |
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