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Related Experiment Videos

Surgery in the aged in Korea

J P Kim1, S J Kim, J H Lee

  • 1Department of Surgery, College of Medicine, Seoul National University Hospital, Korea. jpkim@plaza.snu.ac.kr

Archives of Surgery (Chicago, Ill. : 1960)
|January 23, 1998
PubMed
Summary

Elderly patients (65+) are increasingly undergoing surgery, often for stomach cancer. While they tolerate elective procedures well, emergency surgeries pose higher risks, necessitating careful perioperative management for this growing demographic.

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Area of Science:

  • Geriatric Surgery
  • Surgical Oncology
  • Abdominal Surgery

Background:

  • The proportion of elderly patients (65 years and older) undergoing surgical procedures has notably increased.
  • Malignant neoplasms, particularly stomach cancer, are more prevalent in older surgical patient populations.
  • Acute surgical conditions in the elderly often present with more severe underlying pathologies, including malignancies.

Purpose of the Study:

  • To compare clinical characteristics and postoperative outcomes of Korean surgical patients aged 65 years and older with those of younger patients.
  • To evaluate the impact of age on surgical management and outcomes for common conditions like stomach cancer, acute surgical abdomen, and abdominal wall hernia.

Main Methods:

  • Retrospective review of medical records from an adult university hospital in Korea.

Related Experiment Videos

  • Analysis of 2893 surgical patients from 1994-1995, categorized into three age groups: 40 years and younger, 41-64 years, and 65 years and older.
  • Data collected included demographics, disease patterns, operative details, hospital course, postoperative complications, and mortality.

    • Main Results:

    • The 65+ age group constituted a significant and increasing proportion of surgical patients, with stomach cancer being the most common diagnosis.
    • Elderly patients (65+) exhibited poorer preoperative physical status and more eventful perioperative courses, especially for acute surgical abdomen.
    • Despite poorer preoperative status, no significant differences in resectability, length of hospitalization, postoperative complications, or mortality were observed between age groups for elective procedures; however, emergency operations in the elderly showed higher complication rates.

    Conclusions:

    • Elderly patients (65+) can tolerate elective major surgeries, such as radical gastrectomy, with optimal perioperative care, despite their generally poorer physical condition.
    • Emergency surgical interventions in the elderly are associated with poorer outcomes and higher complication rates, underscoring the need for cautious management.
    • The aging surgical population requires a comprehensive and careful perioperative approach, recognizing their candidacy for surgery while mitigating risks associated with emergency procedures.