title: Perioperative outcomes of elderly patients undergoing laparoscopic renal procedures.
abstract: OBJECTIVE
  To assess the perioperative outcomes in patients >75 years old to better define the role of laparoscopic renal surgery in this expanding segment of the U.S. population. The outcomes of elderly patients undergoing laparoscopic renal procedures are less well defined than those of younger patients.
  
  
  METHODS
  We retrospectively reviewed the records of 115 patients >75 years old who had undergone laparoscopic renal surgery. The clinical and pathologic features and complication rates were analyzed. The patients were substratified according to the type of laparoscopic procedure performed and extreme age (>80 years).
  
  
  RESULTS
  The mean age of our 115 patients was 79.9 years (range 75-91). The median estimated blood loss was 200 mL (interquartile range 100-387). The transfusion rate was 9.6%. The median length of stay was 4 days (interquartile range 3-5). The overall complication rate for the entire cohort was 22.6% and was 13.7% in those >80 years. The number of patients who experienced a complication was 22 (19.1%). Patients with a Charlson comorbidity index >2 were more likely to experience a perioperative complication than were patients with a Charlson comorbidity index <1 (35% vs 16%; P = .034).
  
  
  CONCLUSIONS
  Our data support the safety and feasibility of laparoscopic renal procedures in elderly patients. Furthermore, this safety extends to patients of advanced age (>80 years). The overall complication rates and other perioperative parameters appear to be comparable to those in published studies; however, patients with a Charlson comorbidity index >2 are at a greater risk of complications in the perioperative period.
authors.affiliation: James Buchanan Brady Urologic Institute, Johns Hopkins Medical Institutions, Baltimore, Maryland 21287, USA. tguzzo1@jhmi.edu
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Guzzo
authors.forename: Mohamad E
authors.initials: ME
authors.lastname: Allaf
authors.forename: Phillip M
authors.initials: PM
authors.lastname: Pierorazio
authors.forename: Daniel
authors.initials: D
authors.lastname: Miller
authors.forename: Brian K
authors.initials: BK
authors.lastname: McNeil
authors.forename: Louis R
authors.initials: LR
authors.lastname: Kavoussi
authors.forename: Christian P
authors.initials: CP
authors.lastname: Pavlovich
authors.forename: Edward M
authors.initials: EM
authors.lastname: Schaeffer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D008297:Male; D009392:Nephrectomy / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D016896:Treatment Outcome