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Laparoscopic radical nephrectomy in the elderly
Author(s) -
Varkarakis Ioannis,
Neururer Richard,
Harabayashi Toru,
Bartsch Georg,
Peschel Reichard
Publication year - 2004
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2004.04994.x
Subject(s) - medicine , anesthesiology , perioperative , nephrectomy , surgery , laparoscopy , randomized controlled trial , retrospective cohort study , american society of anesthesiologists , comorbidity , convalescence , anesthesia , kidney
Authors from Innsbruck present their work in laparoscopic radical nephrectomy in elderly patients. They evaluated the outcome of this technique in patients over 75 years old and compared the results with a similar number of patients aged less than 75 years who had the same procedure. Despite more comorbid conditions in the older group the final outcome was equally as good as in the younger patients. Hormone‐refractory prostate cancer is becoming a matter of great concern, and authors from Paris describe their experience with a combination of docetaxel and zoledronic acid in this condition. In this early report, they found the use of these agents to be promising, and recommend the setting up of a prospective randomized trial. OBJECTIVE To evaluate the efficacy and outcome of laparoscopic radical nephrectomy (LRN) in patients aged >75 years, and to compare the results with those obtained from patients younger than this undergoing laparoscopic surgery for the same indication. PATIENTS AND METHODS From a retrospective review of 33 patients aged >75 years undergoing LRN, 28 were for tumour. A group of 28 consecutive patients aged <75 years undergoing laparoscopy for the same indication were used for comparison. The two groups were compared for American Society of Anesthesiology (ASA) physical status score, comorbidity, previous surgical history, operative duration, estimated blood loss, tumour size, complications during and after surgery, conversion rates, time to oral intake and drain removal, perioperative mortality and hospital stay. RESULTS Only the initial ASA score was significantly higher for the older patients. All other variables before, during and after surgery were similar for both groups. CONCLUSIONS The final outcome of laparoscopic surgery in elderly patients was as promising as in their younger counterparts. Therefore, elderly patients should not be excluded from LRN, even though they usually present with more comorbidities.