Clinical Gastroenterology Vol.30 No.4(11)

Theme Digestive Diseases of the Aged Over 85 -- the Characteristics and Therapeutic Points
Title The Problem in Digestive Surgical Treatment for the Oldest‒old Patient
Publish Date 2015/04
Author Nobuhiko Taniai Department of Gastrointestinal and Hepato‒Biliary‒Pancretic Surgery, Nippon Medical School
Author Hiroshi Yoshida Department of Surgery, Tama Nagayama Hospital, Nippon Medical School
Author Eiji Uchida Department of Gastrointestinal and Hepato‒Biliary‒Pancretic Surgery, Nippon Medical School
[ Summary ] The growing elderly population in society has been accompanied by a rapid rise in the age of patients who undergo digestive tract surgery. Super‒elderly patients (aged >85 years) are at increased risk due to age‒related comorbidities involving multiple organs, decreased organ function, malnutrition, compromised immune function, and cognitive decline. The indications for surgery and the operative techniques of choice should be decided based such risks and on the radical nature of surgery required. Limited or minimally invasive surgery is often selected in order to avoid postoperative complications. In recent years, minimally invasive laparoscopic surgery has been performed in super‒elderly patients, and good outcomes have been reported. However, because perioperative complications can lead to death, it is essential to provide individualized perioperative care after a full assessment of the age‒related characteristics of each organ system.
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