[The surgical risk of liver resections for neoplasms in the elderly patient].
For patients who are candidates for surgical resection of the liver, advanced age has, for many years, been considered to be a limiting factor or has precluded intervention. More recently, improvements in diagnostic, surgical and anaesthetic techniques and the increase in the average age of the population have gradually broadened the indications for hepatic resection in elderly patients. The factors for reappraisal of the surgical risk of liver resection in elderly patients are discussed here. Comparative data are also presented on the mortality, morbidity and post-operative changes in blood chemistry parameters in 90 patients who underwent hepatic resection: 33 patients over 65 years of age (group A) and 57 under 65 years (group B). In group A, compared to group B, mortality (3% versus 5%) and the percentage of patients with post-operative complications (27% versus 37%) were not significantly different. The incidence of post-operative complications correlated more closely with specific risk factors (elevated pre-operative "ASA score" from associated disease) than with age itself. Analysis of the regressions did not reveal important relationships between age and changes in the blood chemistry parameters. These results help to support the idea that advanced age alone is not now an absolute contra-indication to major liver resection.
Cattedra di Chirurgia Geriatrica, Università Cattolica del Sacro Cuore, Roma.
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Nuzzo
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Giovannini
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Giuliante
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Boldrini
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Chiarla
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Tebala
D017677:Age Distribution; D000368:Aged; D016009:Chi-Square Distribution; D000075202:Contraindications; D005260:Female; D006498:Hepatectomy / Q000379:methods / Q000706:statistics & numerical data*; D006801:Humans; D016018:Least-Squares Analysis; D008113:Liver Neoplasms / Q000097:blood / Q000453:epidemiology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000097:blood / Q000453:epidemiology; D012307:Risk Factors
Il rischio operatorio delle resezioni epatiche per neoplasia nel paziente anziano.