Emergency surgery for bowel obstruction in extremely aged patients

Area of Science:

• Geriatric Surgery
• Gastrointestinal Surgery
• Emergency Medicine

Background:

• Increasing life expectancy leads to more elderly patients requiring surgery for bowel obstruction.
• Elderly patients often have comorbidities and reduced physiological reserve, increasing surgical risks, especially in emergencies.
• This study evaluates treatment and outcomes for patients over 85 undergoing emergency surgery for intestinal occlusion.

Purpose of the Study:

• To compare outcomes of emergency bowel obstruction surgery in patients over 85 years old versus those 85 years old and younger.
• To identify factors influencing morbidity and mortality in elderly patients undergoing emergency intestinal occlusion surgery.

Main Methods:

• Retrospective analysis of 278 patients undergoing emergency surgery for acute bowel obstruction.
• Patients were divided into two groups: Group A (>85 years) and Group B (≤85 years).
• Comparison of etiological factors, surgical procedures, morbidity, and mortality rates between the two groups.

Main Results:

• The elderly group (Group A) had a higher American Society of Anesthesiologists (ASA) score, indicating higher surgical risk.
• No significant differences were found in obstruction etiology (except for more frequent colon volvulus in the elderly), procedure type, hospital stay, or complication rates.
• Perioperative mortality was significantly higher in the elderly group, primarily due to cardiovascular and respiratory events linked to comorbidities.

Conclusions:

• Early diagnosis and treatment of bowel obstruction can yield positive outcomes even in extremely elderly patients.
• Aggressive evaluation and management of comorbidities, alongside cardiorespiratory risk reduction, are crucial for improving postoperative survival in this population.