TITLE:
Urologic Laparoscopic Surgeries in Elderly: Analysis of Pre-Operative Risk Factors and Postoperative Complications
AUTHORS:
Sompol Permpongkosol
KEYWORDS:
Urologic; Laparoscopic Surgery; Elderly; Complications; Risk Factors; Clavien Classification System
JOURNAL NAME:
Open Journal of Urology,
Vol.3 No.5,
September
4,
2013
ABSTRACT: Purpose: The aging of the
population leads to increases in the prevalence of symptomatic urologic
diseases. The aim of this study is the analysis of pre-operative risk factors
and postoperative complications in patients over the age of 60 years undergoing
elective laparoscopic urologic surgery. Patients and Methods: A
retrospective study was conducted of 113 patients 60 years of age or older who
underwent urologic laparoscopic surgery by a single surgeon (SP). The preoperative
physical status and systemic complications, operation time, postoperative
complications, postoperative hospital stay and other clinical features of the
patients were reviewed. Complications were classified according to the recently
revised Clavien classification system. Statistical analysis was done using
Univariate analysis and the Fisher Exact test. Results: Laparoscopic
urologic surgery was performed on 113 patients 60 years old and over, with
an average age of 69.6 years. Associated diseases were found in 92% of them.
Pelvic surgery (65; 57.5%) was the main reason for surgery. There were 5 (4.4%)
conversions to open surgery and 0% mortality. The overall complication rate was
10 patients (8.8%). Among 9 (7.96%) patients with post-operative complications;
Grade I, II, IIIa, IIIb and IV complications were observed in 1.77%, 12.8%,
3.53%, 0.88% and 0.88% of cases, respectively. Sex with male, operative time ≥
250 min and cancer had high risk ratio (2.76, 2.11 and 3.02, respectively);
however the correlations of all of preoperative risk factors and postoperative
complications showed no statistically significant differences. Conclusions: Laparoscopic surgical treatment of urologic disease in elderly patients
performed is feasible and well tolerated, with low perioperative morbidity and
a good overall survival rate. Pre-operative risk factors may not influence
postoperative complications in patients over the age of 60 years undergoing
elective laparoscopic urologic surgery.