Is gastrectomy safe in the elderly? A single institution review

Area of Science:

• Geriatric Surgery
• Gastrointestinal Oncology
• Surgical Outcomes Research

Background:

• The aging population in the United States necessitates understanding surgical risks in elderly patients.
• Previous studies indicate major abdominal operations are feasible in older adults but associated with increased complications.

Purpose of the Study:

• To determine the morbidity and mortality rates in elderly patients undergoing gastric resection.
• To compare outcomes between patients younger than 75 and those 75 years or older.

Main Methods:

• Retrospective analysis of 157 consecutive gastric resections from January 1998 to July 2007.
• Patients were divided into two groups: <75 years (Group A) and ≥75 years (Group B).
• Clinical data, demographics, length of stay, major morbidity, and in-hospital mortality were analyzed.

Main Results:

• Older patients (Group B) had a significantly longer hospital stay (17.6 vs 11.7 days; P=0.032).
• Major complication rates were significantly higher in older patients (27.6% vs 11.1%; P=0.008).
• In-hospital mortality approached significance (12% vs 4%; P=0.057).

Conclusions:

• Gastric resection in elderly patients is associated with increased length of hospital stay and higher complication rates.
• Despite similar disease prevalence, older age independently increases surgical risk for gastric resection.
• Preoperative counseling regarding these risks is essential for elderly patients considering gastric resection.