title: Complications of liver resection in geriatric patients.
abstract: Introduction and aims. Liver resection is the treatment of choice for many primary and secondary liver diseases. Most studies in the elderly have reported resection of primary and secondary liver tumors, especially hepatocellular carcinoma and colorectal metastatic cancer. However, over the last two decades, hepatectomy has become safe and is now performed in the older population, implying a paradigm shift in the approach to these patients.
  
  
  
  We retrospectively evaluated the risk factors for postoperative complications in patients over 65 years of age in comparison with those under 65 years of age after liver resection (n = 360). The set comprised 127 patients older than 65 years (35%) and 233 patients younger than 65 years (65%).
  
  
  
  In patients younger than 65 years, there was a significantly higher incidence of benign liver tumors (P = 0.0073); in those older than 65 years, there was a significantly higher incidence of metastasis of colorectal carcinoma to the liver (0.0058). In patients older than 65 years, there were significantly more postoperative cardiovascular complications (P = 0.0028). Applying multivariate analysis, we did not identify any independent risk factors for postoperative complications. The 12-month survival was not significantly different (younger versus older patients), and the 5-year survival was significantly worse in older patients (P = 0.0454).
  
  
  
  In the case of liver resection, age should not be a contraindication. An individualized approach to the patient and multidisciplinary postoperative care are the important issues.
authors.affiliation: Surgery Clinic and Transplant Center, University Hospital Martin and Jessenius Faculty of Medicine Comenius University, Martin, Slovakia.
authors.forename: Ivana
authors.initials: I
authors.lastname: Dedinská
authors.affiliation: Surgery Clinic and Transplant Center, University Hospital Martin and Jessenius Faculty of Medicine Comenius University, Martin, Slovakia.
authors.forename: Ludovít
authors.initials: L
authors.lastname: Laca
authors.affiliation: Surgery Clinic and Transplant Center, University Hospital Martin and Jessenius Faculty of Medicine Comenius University, Martin, Slovakia.
authors.forename: Juraj
authors.initials: J
authors.lastname: Miklušica
authors.affiliation: Surgery Clinic and Transplant Center, University Hospital Martin and Jessenius Faculty of Medicine Comenius University, Martin, Slovakia.
authors.forename: Blazej
authors.initials: B
authors.lastname: Palkoci
authors.affiliation: Surgery Clinic and Transplant Center, University Hospital Martin and Jessenius Faculty of Medicine Comenius University, Martin, Slovakia.
authors.forename: Petra
authors.initials: P
authors.lastname: Skálová
authors.affiliation: Surgery Clinic and Transplant Center, University Hospital Martin and Jessenius Faculty of Medicine Comenius University, Martin, Slovakia.
authors.forename: Slavomíra
authors.initials: S
authors.lastname: Lauková
authors.affiliation: Clinic of Anesthesiology and Intensive Medicine, University Hospital Martin and Jessenius Faculty of Medicine, Comenius University, Martin, Slovakia.
authors.forename: Denisa
authors.initials: D
authors.lastname: Osinová
authors.affiliation: Clinic of Internal Medicine I, University Hospital Martin and Jessenius Faculty of Medicine Comenius University, Martin, Slovakia.
authors.forename: Simona
authors.initials: S
authors.lastname: Strmeňová
authors.affiliation: Surgery Clinic and Transplant Center, University Hospital Martin and Jessenius Faculty of Medicine Comenius University, Martin, Slovakia.
authors.forename: Ján
authors.initials: J
authors.lastname: Janík
authors.affiliation: Clinic of Internal Medicine I, University Hospital Martin and Jessenius Faculty of Medicine Comenius University, Martin, Slovakia.
authors.forename: Marián
authors.initials: M
authors.lastname: Mokáň
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation / Q000009:adverse effects* / Q000401:mortality; D016009:Chi-Square Distribution; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects* / Q000379:methods / Q000401:mortality; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D018579:Patient Selection; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D018154:Slovakia; D013997:Time Factors; D016896:Treatment Outcome