Skip to main content

Advertisement

SpringerLink
Log in

The use of emergency laparoscopy for acute abdomen in the elderly: the FRAILESEL Italian Multicenter Prospective Cohort Study

  • Original Article
  • Published:
Updates in Surgery Aims and scope Submit manuscript

Abstract

As the world population is aging rapidly, emergency abdominal surgery for acute abdomen in the elderly represents a global issue, both in developed and developing countries. Data regarding all the elderly patients who underwent emergency abdominal surgery from January 2017 to December 2017 at 36 Italian surgical departments were analyzed with the aim to appraise the contemporary reality regarding the use of emergency laparoscopy for acute abdomen in the elderly. 1993 patients were enrolled. 1369 (68.7%) patients were operated with an open technique; whereas, 624 (31.3%) underwent a laparoscopic operation. The postoperative morbidity rate was 32.6%, with a statically significant difference between the open and the laparoscopic groups (36.2% versus 22.1%, p < 0.001). The reported mortality rate was 8.8%, with a statistically significant difference between the open and the laparoscopic groups (11.2% versus 2.2%, p < 0.001). Our results demonstrated that patients in the ASA II (58.1%), ASA III (68.7%) and ASA IV (88.5%) groups were operated with the traditional open technique in most of the cases. Only a small percentage of patients underwent laparoscopy for perforated gastro-duodenal ulcer repair (18.9%), adhesiolyses with/without small bowel resection (12.2%), and large bowel resection (10.7%). Conversion to open technique was associated with a higher mortality rate (11.1% versus 2.2%, p < 0.001) and overall morbidity (38.9% versus 22.1%, p = 0.001) compared with patients who did not undergo conversion. High creatinine (p < 0.001) and glycaemia (p = 0.006) levels, low hemoglobin levels (p < 0.001), oral anticoagulation therapy (p = 0.001), acute respiratory failure (p < 0.001), presence of malignancy (p = 0.001), SIRS (p < 0.001) and open surgical approach (p < 0.001) were associated with an increased risk of postoperative morbidity. Regardless of technical progress, elderly patients undergoing emergency surgery are at very high risk for in-hospital complications. A detailed analysis of complications and mortality in the present study showed that almost 9% of elderly patients died after surgery for acute abdomen, and over 32% developed complications.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. National Institute on Aging (NIA) (2018) Available at: https://www.nia.nih.gov. Accessed 22 May 2019

  2. ISTAT: Stime per l’anno 2016. 2017, Available at: http://www4.istat.it/it/anziani. Accessed April 1, 2019

  3. Pisano M, Ceresoli M, Cimbanassi S, Gurusamy K, Coccolini F, Borzellino G, Costa G, Allievi N, Amato B, Boerma D, Calcagno P, Campanati L, Campanile FC, Casati A, Chiara O, Crucitti A, di Saverio S, Filauro M, Gabrielli F, Guttadauro A, Kluger Y, Magnone S, Merli C, Poiasina E, Puzziello A, Sartelli M, Catena F, Ansaloni L (2019) 2017 WSES and SICG guidelines on acute calcolous cholecystitis in elderly population. World J Emerg Surg. https://doi.org/10.1186/s13017-019-0224-7

    Article  PubMed  PubMed Central  Google Scholar 

  4. Costa G, Tomassini F, Tierno SM, Venturini L, Frezza B, Cancrini G, Mero A, Lepre L (2009) Emergency colonic surgery: analysis of risk factors predicting morbidity and mortality. Chir Ital 61:565–571

    PubMed  Google Scholar 

  5. Poillucci G, Podda M, Pisanu A, Mortola L, Dalla Caneva P, Massa G, Costa G, Savastano R, Cillara N, ERASO (Elderly Risk Assessment And Surgical Outcome) Collaborative Study Group (2019) Risk factors for postoperative morbidity following appendectomy in the elderly: a nationwide prospective cohort study. Eur J Trauma Emerg Surg 69:531–540

    Google Scholar 

  6. Saunders DI, Murray D, Pichel AC, Varley S, Peden CJ, Emergency Laparotomy Network UK (2012) Variations in mortality after emergency laparotomy: the first report of the UK Emergency Laparotomy Network. Br J Anaesth 109:368–375

    CAS  PubMed  Google Scholar 

  7. Green G, Shaikh I, Fernandes R, Wegstapel H (2013) Emergency laparotomy in octogenarians: a 5-year study of morbidity and mortality. World J Gastrointest Surg 5:216–221

    PubMed  PubMed Central  Google Scholar 

  8. Kettunen J, Paajanen H, Kostiainen S (1995) Emergency abdominal surgery in the elderly. Hepatogastroenterology 42:106–108

    CAS  PubMed  Google Scholar 

  9. McGillicuddy EA, Schuster KM, Davis KA, Longo WE (2009) Factors predicting morbidity and mortality in emergency colorectal procedures in elderly patients. Arch Surg 144:1157–1162

    PubMed  Google Scholar 

  10. Iversen LH, Bülow S, Christensen IJ, Laurberg S, Harling H, Danish Colorectal Cancer Group (2008) Postoperative medical complications are the main cause of early death after emergency surgery for colonic cancer. Br J Surg 95:1012–1019

    CAS  PubMed  Google Scholar 

  11. NCEPOD Classification of Intervention (2004) Reference Source

  12. Costa G, Massa G, ERASO (Elderly Risk Assessment for Surgical Outcome) Collaborative Study Group (2018) Frailty and emergency surgery in the elderly: protocol of a prospective, multicenter study in Italy for evaluating perioperative outcome (The FRAILESEL Study). Updates Surg 70:97–104

    PubMed  Google Scholar 

  13. von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, Initiative STROBE (2014) The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. Int J Surg 12:1495–1499

    Google Scholar 

  14. Dindo D, Demartines N, Clavien PA (2004) Classification of Surgical Complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213

    PubMed  PubMed Central  Google Scholar 

  15. Office for National Statistics (ONS) (2018) National population projections 2014-based statistical bulletin 2015. Available at: https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationprojections/bulletins/nationalpopulationprojections/2015-10-292015. Accessed 1 Apr 2019

  16. ISTAT. Noi Italia 2019. Available at: http://noi-italia.istat.it. Accessed December 22, 2019

  17. Desserud KF, Veen T, Søreide K (2016) Emergency general surgery in the geriatric patient. Br J Surg. https://doi.org/10.1002/bjs.10044

    Article  PubMed  Google Scholar 

  18. McLean RC, McCallum IJ, Dixon S, O’Loughlin P (2016) A 15-year retrospective analysis of the epidemiology and outcomes for elderly emergency general surgical admissions in the North East of England: a case for multidisciplinary geriatric input. Int J Surg 28:13–21

    PubMed  Google Scholar 

  19. Stoneham M, Murray D, Foss N (2014) Emergency surgery: the big three–abdominal aortic aneurysm, laparotomy and hip fracture. Anaesthesia 69(Suppl 1):70–80. https://doi.org/10.1111/anae.12492

    Article  PubMed  Google Scholar 

  20. Al-Temimi MH, Griffee M, Enniss TM, Preston R, Vargo D, Overton S, Kimball E, Barton R, Nirula R (2012) When is death inevitable after emergency laparotomy? Analysis of the American College of Surgeons National Surgical Quality Improvement Program database. J Am Coll Surg 215:503–511

    PubMed  Google Scholar 

  21. Jimenez Rodriguez RM, Segura-Sampedro JJ, Flores-Cortés M, López-Bernal F, Martín C, Diaz VP, Ciuro FP, Ruiz JP (2016) Laparoscopic approach in gastrointestinal emergencies. World J Gastroenterol 22:2701–2710

    PubMed  PubMed Central  Google Scholar 

  22. Agresta F, Campanile FC, Podda M, Cillara N, Pernazza G, Giaccaglia V, Ciccoritti L, Ioia G, Mandalà S, La Barbera C, Birindelli A, Sartelli M, Di Saverio S, Joined Italian Surgical Societies Working Group (2017) Current status of laparoscopy for acute abdomen in Italy: a critical appraisal of 2012 clinical guidelines from two consecutive nationwide surveys with analysis of 271,323 cases over 5 years. Surg Endosc 31:1785–1795

    PubMed  Google Scholar 

  23. Mandrioli M, Inaba K, Piccinini A, Biscardi A, Sartelli M, Agresta F, Catena F, Cirocchi R, Jovine E, Tugnoli G, Saverio Di (2016) Advances in laparoscopy for acute care surgery and trauma. World J Gastroenterol 22:668–680

    CAS  PubMed  PubMed Central  Google Scholar 

  24. Pucher PH, Carter NC, Knight BC, Toh S, Tucker V, Mercer SJ (2018) Impact of laparoscopic approach in emergency major abdominal surgery: single-centre analysis of 748 consecutive cases. Ann R Coll Surg Engl 100:279–284

    CAS  PubMed  PubMed Central  Google Scholar 

  25. Cocorullo G, Falco N, Tutino R, Fontana T, Scerrino G, Salamone G, Licari L, Gulotta G (2016) Open versus laparoscopic approach in the treatment of abdominal emergencies in elderly population. G Chir 37:108–112

    CAS  PubMed  PubMed Central  Google Scholar 

  26. Kannan U, Reddy VS, Mukerji AN, Parithivel VS, Shah AK, Gilchrist BF, Farkas DT (2015) Laparoscopic vs open partial colectomy in elderly patients: insights from the American College of Surgeons—National Surgical Quality Improvement Program database. World J Gastroenterol 21:12843–12850

    CAS  PubMed  PubMed Central  Google Scholar 

  27. Cerdán Santacruz C, Frasson M, Flor-Lorente B, Ramos Rodríguez JL, Trallero Anoro M, Millán Scheiding M, Maseda Díaz O, Dujovne Lindenbaum P, Monzón Abad A, García-Granero Ximenez E, ANACO Study Group (2017) Laparoscopy may decrease morbidity and length of stay after elective colon cancer resection, especially in frail patients: results from an observational real-life study. Surg Endosc 31:5032–5042

    PubMed  Google Scholar 

  28. Loozen CS, van Ramshorst B, van Santvoort HC, Boerma D (2017) Early Cholecystectomy for acute cholecystitis in the elderly population: a systematic review and meta-analysis. Dig Surg 34:371–379

    PubMed  Google Scholar 

  29. Cao AM, Eslick GD, Cox MR (2016) Early laparoscopic cholecystectomy is superior to delayed acute cholecystitis: a meta-analysis of case-control studies. Surg Endosc 30:1172–1182

    PubMed  Google Scholar 

  30. Antoniou SA, Antoniou GA, Koch OO, Pointner R, Granderath FA (2014) Meta-analysis of laparoscopic vs open cholecystectomy in elderly patients. World J Gastroenterol 20:17626–17634

    PubMed  PubMed Central  Google Scholar 

  31. Harji DP, Griffiths B, Burke D, Sagar PM (2014) Systematic review of emergency laparoscopic colorectal resection. Br J Surg 101:e126-33. https://doi.org/10.1002/bjs.9348

    Article  PubMed  Google Scholar 

  32. Cirocchi R, Fearnhead N, Vettoretto N, Cassini D, Popivanov G, Henry BM, Tomaszewski K, D’Andrea V, Davies J, Di Saverio S (2019) The role of emergency laparoscopic colectomy for complicated sigmoid diverticulits: a systematic review and meta-analysis. Surgeon 17:360–369

    PubMed  Google Scholar 

  33. Veldkamp R, Kuhry E, Hop WC, Jeekel J, Kazemier G, Bonjer HJ, Haglind E, Påhlman L, Cuesta MA, Msika S, Morino M, Lacy AM, COlon cancer Laparoscopic or Open Resection Study Group (2005) Laparoscopic surgery versus open surgery for colon cancer: short-term outcomes of a randomised trial. Lancet Oncol 6:477–484

    PubMed  Google Scholar 

  34. van der Pas MH, Haglind E, Cuesta MA, Fürst A, Lacy AM, Hop WC, Bonjer HJ, COlorectal cancer Laparoscopic or Open Resection II (COLOR II) Study Group (2013) Laparoscopic versus open surgery for rectal cancer (COLOR II): short-term outcomes of a randomised, phase 3 trial. Lancet Oncol 14:210–218

    PubMed  Google Scholar 

  35. Guillou PJ, Quirke P, Thorpe H, Walker J, Jayne DG, Smith AM, Heath RM, Brown JM, MRC CLASICC trial group (2005) Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. Lancet 365:1718–1726

    PubMed  Google Scholar 

  36. Keller DS, Senagore AJ, Fitch K, Bochner A, Haas EM (2017) A new perspective on the value of minimally invasive colorectal surgery-payer, provider, and patient benefits. Surg Endosc 31:2846–2853

    PubMed  Google Scholar 

  37. Szomstein S, Lo Menzo E, Simpfendorfer C, Zundel N, Rosenthal RJ (2006) Laparoscopic lysis of adhesions. World J Surg 30:535–540

    PubMed  Google Scholar 

  38. Sharma R, Reddy S, Thoman D, Grotts J, Ferrigno L (2015) Laparoscopic versus open bowel resection in emergency small bowel obstruction: analysis of the national surgical quality improvement program database. J Laparoendosc Adv Surg Tech A 25:625–630

    PubMed  Google Scholar 

  39. Johnson KN, Chapital AB, Harold KL, Merritt MV, Johnson DJ (2012) Laparoscopic management of acute small bowel obstruction: evaluating the need for resection. J Trauma Acute Care Surg 72:25–31

    PubMed  Google Scholar 

  40. Nagle A, Ujiki M, Denham W, Murayama K (2004) Laparoscopic adhesiolysis for small bowel obstruction. Am J Surg 187:464–470

    PubMed  Google Scholar 

  41. Byrge N, Barton RG, Enniss TM, Nirula R (2013) Laparoscopic versus open repair of perforated gastroduodenal ulcer: a National Surgical Quality Improvement Program analysis. Am J Surg 206:957–963

    PubMed  Google Scholar 

  42. Wang YR, Richter JE, Dempsey DT (2010) Trends and outcomes of hospitalizations for peptic ulcer disease in the United States, 1993 to 2006. Ann Surg 251:51–58

    PubMed  Google Scholar 

  43. Bertleff MJ, Lange JF (2010) Laparoscopic correction of perforated peptic ulcer: first choice? A review of literature. Surg Endosc 24:1231–1239

    PubMed  Google Scholar 

  44. Møller MH, Larsson HJ, Rosenstock S, Jørgensen H, Johnsen SP, Madsen AH, Adamsen S, Jensen AG, Zimmermann-Nielsen E, Thomsen RW, Danish Clinical Register of Emergency Surgery (2013) Quality-of-care initiative in patients treated surgically for perforated peptic ulcer. Br J Surg 100:543–552

    PubMed  Google Scholar 

  45. Testini M, Portincasa P, Piccinni G, Lissidini G, Pellegrini F, Greco L (2003) Significant factors associated with fatal outcome in emergency open surgery for perforated peptic ulcer. World J Gastroenterol 9:2338–2340

    PubMed  PubMed Central  Google Scholar 

  46. Sheu BF, Chiu TF, Chen JC, Tung MS, Chang MW, Young YR (2007) Risk factors associated with perforated appendicitis in elderly patients presenting with signs and symptoms of acute appendicitis. ANZ J Surg 77:662–666

    PubMed  Google Scholar 

  47. Moazzez A, Mason RJ, Katkhouda N (2013) Thirty-day outcomes of laparoscopic versus open appendectomy in elderly using ACS/NSQIP database. Surg Endosc 27:1061–1071

    PubMed  Google Scholar 

  48. Guller U, Jain N, Peterson ED, Muhlbaier LH, Eubanks S, Pietrobon R (2004) Laparoscopic appendectomy in the elderly. Surgery 135:479–488

    PubMed  Google Scholar 

  49. Ukkonen M, Kivivuori A, Rantanen T, Paajanen H (2015) Emergency Abdominal operations in the elderly: a multivariate regression analysis of 430 consecutive patients with acute abdomen. World J Surg 39:2854–2861

    PubMed  Google Scholar 

  50. Bala M, Kashuk J, Moore EE, Kluger Y, Biffl W, Gomes CA, Ben-Ishay O, Rubinstein C, Balogh ZJ, Civil I, Coccolini F, Leppaniemi A, Peitzman A, Ansaloni L, Sugrue M, Sartelli M, Di Saverio S, Fraga GP, Catena F (2017) Acute mesenteric ischemia: guidelines of the World Society of Emergency Surgery. World J Emerg Surg. https://doi.org/10.1186/s13017-017-0150-5

    Article  PubMed  PubMed Central  Google Scholar 

  51. Di Saverio S, Coccolini F, Galati M, Smerieri N, Biffl WL, Ansaloni L, Tugnoli G, Velmahos GC, Sartelli M, Bendinelli C, Fraga GP, Kelly MD, Moore FA, Mandalà V, Mandalà S, Masetti M, Jovine E, Pinna AD, Peitzman AB, Leppaniemi A, Sugarbaker PH, Goor HV, Moore EE, Jeekel J, Catena F (2013) Bologna guidelines for diagnosis and management of adhesive small bowel obstruction (ASBO): 2013 update of the evidence-based guidelines from the world society of emergency surgery ASBO working group. World J Emerg Surg. https://doi.org/10.1186/1749-7922-8-42

    Article  PubMed  PubMed Central  Google Scholar 

  52. Tolstrup MB, Watt SK, Gögenur I (2017) Morbidity and mortality rates after emergency abdominal surgery: an analysis of 4346 patients scheduled for emergency laparotomy or laparoscopy. Langenbecks Arch Surg 402:615–623

    PubMed  Google Scholar 

Download references

Acknowledgements

List of the Elderly Risk Assessment and Surgical Outcome (ERASO) Collaborative Study Group members (endorsed by SICUT, ACOI, SICG, SICE, and the Italian Chapter of the WSES): F. Agresta, G. Alemanno, G. Anania, M. Antropoli, G. Argenio, J. Atzeni, N. Avenia, A. Azzinnaro, G. Baldazzi, G. Balducci, G. Barbera, G. Bellanova, C. Bergamini, L. Bersigotti, P. P. Bianchi, C. Bombardini, G. Borzellino, S. Bozzo, G. Brachini, G. M. Buonanno, T. Canini, S. Cardella, G. Carrara, D. Cassini, M. Castriconi, G. Ceccarelli, D. Celi, M. Ceresoli, M. Chiarugi, N. Cillara, F. Cimino, L. Cobuccio, G. Cocorullo, E. Colangelo, G. Costa, A. Crucitti, P. Dalla Caneva, M. De Luca, A. de Manzoni Garberini, C. De Nisco, M. De Prizio, A. De Sol, A. Dibella, T. Falcioni, N. Falco, C. Farina, E. Finotti, T. Fontana, G. Francioni, P. Fransvea, B. Frezza, G. Garulli, M. Genna, S. Giannessi, A. Gioffrè, A. Giordano, D. Gozzo, S. Grimaldi, G. Gulotta, V. Iacopini, T. Iarussi, E. Laterza, A. Leonardi, L. Lepre, G. Luridiana, A. Malagnino, G. Mar, P. Marini, R. Marzaioli, G. Massa, V. Mecarelli, A. Mingoli, G. Nigri, S. Occhionorelli, N. Paderno, G. M. Palini, D. Paradies, M. Paroli, F. Perrone, L. Petruzzelli, A. Pezzolla, D. Piazza, V. Piazza, M. Piccoli, A. Pisanu, M. Podda, G. Poillucci, R. Porfidia, G. Rossi, P. Ruscelli, A. Spagnoli, R. Sulis, D. Tartaglia, C. Tranà, A. Travaglino, P. Tomaiuolo, A. Valeri, G. Vasquez, M. Zago, E. Zanoni.

Author information

Authors and Affiliations

  1. Emergency Surgery Unit, Sant’Andrea Teaching Hospital, “La Sapienza” University of Rome, Rome, Italy

    Gianluca Costa, Pietro Fransvea & Genoveffa Balducci

  2. Department of General, Emergency and Minimally Invasive Surgery, Cagliari University Hospital “D. Casula”, University of Cagliari, SS 554, Km 4,500, Monserrato, 09042, Cagliari, Italy

    Mauro Podda & Adolfo Pisanu

  3. Department of General, Emergency and Transplant Surgery, Ospedale di Circolo e “Fondazione Macchi”, ASST Sette Laghi, University of Insubria, Varese, Italy

    Francesco Maria Carrano

  4. Department of Medicine and Surgical Sciences and Biotechnologies, “La Sapienza” University of Rome, Polo Pontino, Latina, Italy

    Angelo Iossa

  5. Department of General Surgery, Adria Civil Hospital, Adria, Italy

    Ferdinando Agresta

Authors
  1. Gianluca Costa
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Pietro Fransvea
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mauro Podda
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Adolfo Pisanu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Francesco Maria Carrano
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Angelo Iossa
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Genoveffa Balducci
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Ferdinando Agresta
    View author publications

    You can also search for this author in PubMed Google Scholar

Consortia

the ERASO (Elderly Risk Assessment and Surgical Outcome) Collaborative Study Group

  • F. Agresta
  • , G. Alemanno
  • , G. Anania
  • , M. Antropoli
  • , G. Argenio
  • , J. Atzeni
  • , N. Avenia
  • , A. Azzinnaro
  • , G. Baldazzi
  • , G. Balducci
  • , G. Barbera
  • , G. Bellanova
  • , C. Bergamini
  • , L. Bersigotti
  • , P. P. Bianchi
  • , C. Bombardini
  • , G. Borzellino
  • , S. Bozzo
  • , G. Brachini
  • , G. M. Buonanno
  • , T. Canini
  • , S. Cardella
  • , G. Carrara
  • , D. Cassini
  • , M. Castriconi
  • , G. Ceccarelli
  • , D. Celi
  • , M. Ceresoli
  • , M. Chiarugi
  • , N. Cillara
  • , F. Cimino
  • , L. Cobuccio
  • , G. Cocorullo
  • , E. Colangelo
  • , G. Costa
  • , A. Crucitti
  • , P. Dalla Caneva
  • , M. De Luca
  • , A. de Manzoni Garberini
  • , C. De Nisco
  • , M. De Prizio
  • , A. De Sol
  • , A. Dibella
  • , T. Falcioni
  • , N. Falco
  • , C. Farina
  • , E. Finotti
  • , T. Fontana
  • , G. Francioni
  • , P. Fransvea
  • , B. Frezza
  • , G. Garulli
  • , M. Genna
  • , S. Giannessi
  • , A. Gioffrè
  • , A. Giordano
  • , D. Gozzo
  • , S. Grimaldi
  • , G. Gulotta
  • , V. Iacopini
  • , T. Iarussi
  • , E. Laterza
  • , A. Leonardi
  • , L. Lepre
  • , G. Luridiana
  • , A. Malagnino
  • , G. Mar
  • , P. Marini
  • , R. Marzaioli
  • , G. Massa
  • , V. Mecarelli
  • , A. Mingoli
  • , G. Nigri
  • , S. Occhionorelli
  • , N. Paderno
  • , G. M. Palini
  • , D. Paradies
  • , M. Paroli
  • , F. Perrone
  • , L. Petruzzelli
  • , A. Pezzolla
  • , D. Piazza
  • , V. Piazza
  • , M. Piccoli
  • , A. Pisanu
  • , M. Podda
  • , G. Poillucci
  • , R. Porfidia
  • , G. Rossi
  • , P. Ruscelli
  • , A. Spagnoli
  • , R. Sulis
  • , D. Tartaglia
  • , C. Tranà
  • , A. Travaglino
  • , P. Tomaiuolo
  • , A. Valeri
  • , G. Vasquez
  • , M. Zago
  •  & E. Zanoni

Contributions

GC: Study conception and design, literature search, acquisition, interpretation and analysis of data; drafting and critically revising the article for important intellectual content; and final approval of the version to be published. PF: Study conception and design, literature search, acquisition, interpretation and analysis of data; drafting and critically revising the article for important intellectual content; and final approval of the version to be published. MP: Interpretation and analysis of data; drafting and critically revising the article for important intellectual content; and final approval of the version to be published. AP: Interpretation and analysis of data; drafting and critically revising the article for important intellectual content; and final approval of the version to be published. Francesco MC: Interpretation and analysis of data; drafting and critically revising the article for important intellectual content; and final approval of the version to be published. AI: Interpretation and analysis of data; drafting and critically revising the article for important intellectual content; and final approval of the version to be published. GB: Interpretation and analysis of data; critically revising the article for important intellectual content; and final approval of the version to be published. FA: Study conception and design, literature search, interpretation and analysis of data; drafting and critically revising the article for important intellectual content; and final approval of the version to be published.

Corresponding author

Correspondence to Mauro Podda.

Ethics declarations

Conflicts of interest and source of funding

Gianluca Costa, Pietro Fransvea, Mauro Podda, Adolfo Pisanu, Francesco Maria Carrano, Angelo Iossa, Genoveffa Balducci, and Ferdinando Agresta, have no conflict of interest to declare. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Ethical approval

The study has been approved by the Ethics Committee of the University “La Sapienza” (Rome, Italy. Protocol ID: Rif_CE_452_2016). Secondary approval was obtained from all ethics committees of the other participating centers. The study protocol was registered at ClinicalTrials.gov (ClinicalTrials.gov identifier: NCT02825082).

Research involving human participants and/or animals

The study has been performed in accordance with the ethical standards of the institutional and/or national research committee, and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

The members of the ERASO (Elderly Risk Assessment and Surgical Outcome) Collaborative Study Group mentioned in “Acknowledgements” section.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Costa, G., Fransvea, P., Podda, M. et al. The use of emergency laparoscopy for acute abdomen in the elderly: the FRAILESEL Italian Multicenter Prospective Cohort Study. Updates Surg 72, 513–525 (2020). https://doi.org/10.1007/s13304-020-00726-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13304-020-00726-5

Keywords

Search

Navigation