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Laparoscopic antireflux surgery in the elderly.

Y S Khajanchee¹, D R Urbach, N Butler

¹Department of Minimally Invasive Surgery and Surgical Research, Legacy Health System, 501 N. Graham, Suite 120, Portland, OR 97227, USA.

Surgical Endoscopy

|April 19, 2002

Summary

Laparoscopic antireflux surgery is safe and effective for elderly patients with gastroesophageal reflux disease (GERD). Outcomes and quality of life were comparable to younger patients, challenging previous concerns.

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Area of Science:

Gastroenterology
Surgical Oncology
Geriatric Medicine

Background:

Laparoscopic antireflux surgery is often withheld from elderly patients with GERD due to concerns about complications, quality of life, and cost-effectiveness.
This study addresses these concerns by comparing outcomes in elderly and younger GERD patients.

Purpose of the Study:

To compare disease severity, surgical outcomes, and quality of life impacts of laparoscopic antireflux surgery between elderly and young patients with GERD.
To evaluate the safety and efficacy of this procedure in an older population.

Main Methods:

A prospective database of 1100 patients undergoing laparoscopic esophageal procedures was reviewed.
Thirty elderly patients (mean age 71.2 years) with chronic GERD were compared to 30 younger patients (mean age 43.9 years) with at least 6 months follow-up.

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Comparisons included subjective/objective outcomes, operative results, and SF-36 health-related quality of life (HRQL) scores.

Main Results:

Preoperative GERD severity and functional data were similar between groups.
Elderly patients had higher American Society of Anesthesiologists (ASA) scores.
Both groups showed significant improvement in symptoms and esophageal function post-surgery, with no significant differences in complications, hospital stay, or HRQL.

Conclusions:

Laparoscopic antireflux surgery is safe and effective in elderly patients with GERD.
The procedure significantly improves acid reflux and demonstrates comparable outcomes to younger patients.
This challenges the notion that age is a contraindication for this intervention.