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Principles of Geriatric Surgery

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Abstract

With a few obvious exceptions, those of us who are ­surgeons must become geriatric surgeons. The population as a whole is aging, with the most explosive growth in the over 85 year group, and the conditions that require surgery (atherosclerosis, cancer, arthritis, prostatism, cataract, and others) increase in incidence with increasing age. Improving our care of the elderly surgical patient – the raison d’etre of this book – will become progressively more important to us all.

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References

  1. Smith OC (1907) Advanced age as a contraindication to operation. Med Rec (NY) 72:642–644

    Google Scholar 

  2. Ochsner A (1967) Is risk of operation too great in the elderly? Geriatrics 22:121–130

    PubMed  CAS  Google Scholar 

  3. Alexander HR, Turnbull AD, Salamone J, Keefe D, Melendez J (1991) Upper abdominal cancer surgery in the very elderly. J Surg Oncol 47(2):82–86

    Article  PubMed  CAS  Google Scholar 

  4. Bridges CR, Edwards FH, Peterson ED, Coombs LP, Ferguson TB (2003) Cardiac surgery in nonagenarians and centenarians. J Am Coll Surg 197(3):347–356, discussion 356–347

    Article  PubMed  Google Scholar 

  5. Katlic MR (1985) Surgery in centenarians. JAMA 253(21):3139–3141

    Article  PubMed  CAS  Google Scholar 

  6. Ullery BW, Peterson JC, Milla F et al (2008) Cardiac surgery in select nonagenarians: should we or shouldn’t we? Ann Thorac Surg 85(3):854–860

    Article  PubMed  Google Scholar 

  7. Cohen JR, Johnson H, Eaton S, Sterman H, Wise L (1988) Surgical procedures in patients during the tenth decade of life. Surgery 104(4):646–651

    PubMed  CAS  Google Scholar 

  8. Linn BS, Zeppa R (1987) Student attitudes about surgery in older patients before and after the surgical clerkship. Ann Surg 205(3):324–328

    Article  PubMed  CAS  Google Scholar 

  9. Thomas DR, Ritchie CS (1995) Preoperative assessment of older adults. J Am Geriatr Soc 43(7):811–821

    PubMed  CAS  Google Scholar 

  10. Goodney PP, Siewers AE, Stukel TA, Lucas FL, Wennberg DE, Birkmeyer JD (2002) Is surgery getting safer? National trends in operative mortality. J Am Coll Surg 195(2):219–227

    Article  PubMed  Google Scholar 

  11. Storm-Dickerson TL, Horattas MC (2003) What have we learned over the past 20 years about appendicitis in the elderly? Am J Surg 185(3):198–201

    Article  PubMed  Google Scholar 

  12. Elangovan S (1996) Clinical and laboratory findings in acute appendicitis in the elderly. J Am Board Fam Pract 9(2):75–78

    PubMed  CAS  Google Scholar 

  13. Lau WY, Fan ST, Yiu TF, Chu KW, Lee JM (1985) Acute appendicitis in the elderly. Surg Gynecol Obstet 161(2):157–160

    PubMed  CAS  Google Scholar 

  14. Horattas MC, Guyton DP, Wu D (1990) A reappraisal of appendicitis in the elderly. Am J Surg 160(3):291–293

    Article  PubMed  CAS  Google Scholar 

  15. Adedeji OA, McAdam WA (1996) Murphy’s sign, acute cholecystitis and elderly people. J R Coll Surg Edinb 41(2):88–89

    PubMed  CAS  Google Scholar 

  16. Hafif A, Gutman M, Kaplan O, Winkler E, Rozin RR, Skornick Y (1991) The management of acute cholecystitis in elderly patients. Am Surg 57(10):648–652

    PubMed  CAS  Google Scholar 

  17. Parker LJ, Vukov LF, Wollan PC (1997) Emergency department evaluation of geriatric patients with acute cholecystitis. Acad Emerg Med 4(1):51–55

    Article  PubMed  CAS  Google Scholar 

  18. Chen Y, Zheng M, Hu X et al (2008) Fever of unknown origin in elderly people: a retrospective study of 87 patients in China. J Am Geriatr Soc 56(1):182–184

    Article  PubMed  Google Scholar 

  19. Stewart L, Grifiss JM, Jarvis GA, Way LW (2008) Elderly patients have more severe biliary infections: influence of complement-killing and induction of TNFalpha production. Surgery 143(1):103–112

    Article  PubMed  Google Scholar 

  20. Magnuson TH, Ratner LE, Zenilman ME, Bender JS (1997) Laparoscopic cholecystectomy: applicability in the geriatric population. Am Surg 63(1):91–96

    PubMed  CAS  Google Scholar 

  21. Saunders K, Tompkins R, Longmire W Jr, Roslyn J (1991) Bile duct carcinoma in the elderly. A rationale for surgical management. Arch Surg 126(10):1186–1190, discussion 1190–1181

    Article  PubMed  CAS  Google Scholar 

  22. Hilton D, Iman N, Burke GJ et al (2001) Absence of abdominal pain in older persons with endoscopic ulcers: a prospective study. Am J Gastroenterol 96(2):380–384

    Article  PubMed  CAS  Google Scholar 

  23. Rabinovici R, Manny J (1991) Perforated duodenal ulcer in the elderly. Eur J Surg 157(2):121–125

    PubMed  CAS  Google Scholar 

  24. Mulcahy HE, Patchett SE, Daly L, O’Donoghue DP (1994) Prognosis of elderly patients with large bowel cancer. Br J Surg 81(5):736–738

    Article  PubMed  CAS  Google Scholar 

  25. Watters JM, Blakslee JM, March RJ, Redmond ML (1996) The influence of age on the severity of peritonitis. Can J Surg 39(2):142–146

    PubMed  CAS  Google Scholar 

  26. Tedesco P, Lobo E, Fisichella PM, Way LW, Patti MG (2006) Laparoscopic fundoplication in elderly patients with ­gastroesophageal reflux disease. Arch Surg 141(3):289–292, ­discussion 292

    Article  PubMed  Google Scholar 

  27. Pilotto A, Franceschi M, Leandro G et al (2006) Clinical features of reflux esophagitis in older people: a study of 840 consecutive patients. J Am Geriatr Soc 54(10):1537–1542

    Article  PubMed  Google Scholar 

  28. Knutson JW, Slavin RG (1995) Sinusitis in the aged. Optimal management strategies. Drugs Aging 7(4):310–316

    Article  PubMed  CAS  Google Scholar 

  29. Norman DC, Toledo SD (1992) Infections in elderly persons. An altered clinical presentation. Clin Geriatr Med 8(4):713–719

    PubMed  CAS  Google Scholar 

  30. Koch WM, Patel H, Brennan J, Boyle JO, Sidransky D (1995) Squamous cell carcinoma of the head and neck in the elderly. Arch Otolaryngol Head Neck Surg 121(3):262–265

    Article  PubMed  CAS  Google Scholar 

  31. Ehlinger P, Fossion E, Vrielinck L (1993) Carcinoma of the oral cavity in patients over 75 years of age. Int J Oral Maxillofac Surg 22(4):218–220

    Article  PubMed  CAS  Google Scholar 

  32. Chigot JP, Menegaux F, Achrafi H (1995) Should primary hyperparathyroidism be treated surgically in elderly patients older than 75 years? Surgery 117(4):397–401

    Article  PubMed  CAS  Google Scholar 

  33. Thomas PC, Grigg M (1996) Carotid artery surgery in the octogenarian. Aust N Z J Surg 66(4):231–234

    Article  PubMed  CAS  Google Scholar 

  34. Canto JG, Fincher C, Kiefe CI et al (2002) Atypical presentations among Medicare beneficiaries with unstable angina pectoris. Am J Cardiol 90(3):248–253

    Article  PubMed  Google Scholar 

  35. Hellmann DB (2003) Eurekapenia: a disease of medical residency training programs? Pharos Alpha Omega Alpha Honor Med Soc 66(2):24–26

    PubMed  Google Scholar 

  36. Durso SC (2004) A bipolar disorder: eurekaphoria, then discouragement. Pharos Alpha Omega Alpha Honor Med Soc 67(3):49

    PubMed  Google Scholar 

  37. Birim O, Zuydendorp HM, Maat AP, Kappetein AP, Eijkemans MJ, Bogers AJ (2003) Lung resection for non-small-cell lung cancer in patients older than 70: mortality, morbidity, and late survival compared with the general population. Ann Thorac Surg 76(6):1796–1801

    Article  PubMed  Google Scholar 

  38. Brock MV, Kim MP, Hooker CM et al (2004) Pulmonary resection in octogenarians with stage I nonsmall cell lung cancer: a 22-year experience. Ann Thorac Surg 77(1):271–277

    Article  PubMed  Google Scholar 

  39. Keagy BA, Pharr WF, Bowes DE, Wilcox BR (1984) A review of morbidity and mortality in elderly patients undergoing pulmonary resection. Am Surg 50(4):213–216

    PubMed  CAS  Google Scholar 

  40. Au J, el-Oakley R, Cameron EW (1994) Pneumonectomy for bronchogenic carcinoma in the elderly. Eur J Cardiothorac Surg 8(5):247–250

    Article  PubMed  CAS  Google Scholar 

  41. Miller DL, Deschamps C, Jenkins GD, Bernard A, Allen MS, Pairolero PC (2002) Completion pneumonectomy: factors ­affecting operative mortality and cardiopulmonary morbidity. Ann Thorac Surg 74(3):876–883, discussion 883–874

    Article  PubMed  Google Scholar 

  42. Rostad H, Naalsund A, Strand TE, Jacobsen R, Talleraas O, Norstein J (2005) Results of pulmonary resection for lung cancer in Norway, patients older than 70 years. Eur J Cardiothorac Surg 27(2):325–328

    Article  PubMed  Google Scholar 

  43. Demmy TL, Plante AJ, Nwogu CE, Takita H, Anderson TM (2004) Discharge independence with minimally invasive lobectomy. Am J Surg 188(6):698–702

    Article  PubMed  Google Scholar 

  44. Jaklitsch MT, DeCamp MM Jr, Liptay MJ et al (1996) Video-assisted thoracic surgery in the elderly: a review of 307 cases. Chest 110(3):751–758

    Article  PubMed  CAS  Google Scholar 

  45. Nomori H, Horio H, Fuyuno G, Kobayashi R, Yashima H (1996) Respiratory muscle strength after lung resection with special reference to age and procedures of thoracotomy. Eur J Cardiothorac Surg 10(5):352–358

    Article  PubMed  CAS  Google Scholar 

  46. Yim AP (1996) Thoracoscopic surgery in the elderly population. Surg Endosc 10(9):880–882

    Article  PubMed  CAS  Google Scholar 

  47. Cattaneo SM, Park BJ, Wilton AS et al (2008) Use of video-assisted thoracic surgery for lobectomy in the elderly results in fewer complications. Ann Thorac Surg 85(1):231–235, discussion 235–236

    Article  PubMed  Google Scholar 

  48. Patel HJ, Williams DM, Upchurch GR Jr et al (2008) A comparison of open and endovascular descending thoracic aortic repair in patients older than 75 years of age. Ann Thorac Surg 85(5):1597–1603, discussion 1603–1594

    Article  PubMed  Google Scholar 

  49. Bergus BO, Feng WC, Bert AA, Singh AK (1992) Aortic valve replacement (AVR): influence of age on operative morbidity and mortality. Eur J Cardiothorac Surg 6(3):118–121

    Article  PubMed  CAS  Google Scholar 

  50. Salomon NW, Page US, Bigelow JC, Krause AH, Okies JE, Metzdorff MT (1991) Coronary artery bypass grafting in elderly patients. Comparative results in a consecutive series of 469 patients older than 75 years. J Thorac Cardiovasc Surg 101(2):209–217, discussion 217–208

    PubMed  CAS  Google Scholar 

  51. Lytle BW, Navia JL, Taylor PC et al (1997) Third coronary artery bypass operations: risks and costs. Ann Thorac Surg 64(5):1287–1295

    Article  PubMed  CAS  Google Scholar 

  52. Elayda MA, Hall RJ, Reul RM et al (1993) Aortic valve replacement in patients 80 years and older. Operative risks and long-term results. Circulation 88(5 Pt 2):II11–II16

    PubMed  CAS  Google Scholar 

  53. Fortner JG, Lincer RM (1990) Hepatic resection in the elderly. Ann Surg 211(2):141–145

    Article  PubMed  CAS  Google Scholar 

  54. Fong Y, Blumgart LH, Fortner JG, Brennan MF (1995) Pancreatic or liver resection for malignancy is safe and effective for the elderly. Ann Surg 222(4):426–434, discussion 434–427

    PubMed  CAS  Google Scholar 

  55. Escarce JJ, Shea JA, Chen W, Qian Z, Schwartz JS (1995) Outcomes of open cholecystectomy in the elderly: a longitudinal analysis of 21,000 cases in the prelaparoscopic era. Surgery 117(2):156–164

    Article  PubMed  CAS  Google Scholar 

  56. Tsujitani S, Katano K, Oka A, Ikeguchi M, Maeta M, Kaibara N (1996) Limited operation for gastric cancer in the elderly. Br J Surg 83(6):836–839

    Article  PubMed  CAS  Google Scholar 

  57. Gretschel S, Estevez-Schwarz L, Hunerbein M, Schneider U, Schlag PM (2006) Gastric cancer surgery in elderly patients. World J Surg 30(8):1468–1474

    Article  PubMed  Google Scholar 

  58. Okada M, Koike T, Higashiyama M, Yamato Y, Kodama K, Tsubota N (2006) Radical sublobar resection for small-sized non-small cell lung cancer: a multicenter study. J Thorac Cardiovasc Surg 132(4):769–775

    Article  PubMed  Google Scholar 

  59. Mery CM, Pappas AN, Bueno R et al (2005) Similar long-term survival of elderly patients with non-small cell lung cancer treated with lobectomy or wedge resection within the surveillance, epidemiology, and end results database. Chest 128(1):237–245

    Article  PubMed  Google Scholar 

  60. Lawrence VA, Hazuda HP, Cornell JE et al (2004) Functional independence after major abdominal surgery in the elderly. J Am Coll Surg 199(5):762–772

    Article  PubMed  Google Scholar 

  61. Seymour DG, Vaz FG (1989) A prospective study of elderly ­general surgical patients: II Post-operative complications. Age Ageing 18(5):316–326

    Article  PubMed  CAS  Google Scholar 

  62. Dzankic S, Pastor D, Gonzalez C, Leung JM (2001) The prevalence and predictive value of abnormal preoperative laboratory tests in elderly surgical patients. Anesth Analg 93(2):301–308, 302nd contents page

    PubMed  CAS  Google Scholar 

  63. Vaporciyan AA, Merriman KW, Ece F et al (2002) Incidence of major pulmonary morbidity after pneumonectomy: association with timing of smoking cessation. Ann Thorac Surg 73(2):420–425, discussion 425–426

    Article  PubMed  Google Scholar 

  64. Mizushima Y, Noto H, Sugiyama S et al (1997) Survival and prognosis after pneumonectomy for lung cancer in the elderly. Ann Thorac Surg 64(1):193–198

    Article  PubMed  CAS  Google Scholar 

  65. Reilly JJ (1997) Preparing for pulmonary resection: preoperative evaluation of patients. Chest 112(4 Suppl):206S–208S

    Article  PubMed  CAS  Google Scholar 

  66. Goldhaber SZ, Tapson VF (2004) A prospective registry of 5,451 patients with ultrasound-confirmed deep vein thrombosis. Am J Cardiol 93(2):259–262

    Article  PubMed  Google Scholar 

  67. Jacobs LG (2003) Prophylactic anticoagulation for venous thromboembolic disease in geriatric patients. J Am Geriatr Soc 51(10):1472–1478

    Article  PubMed  Google Scholar 

  68. Berlauk JF, Abrams JH, Gilmour IJ, O’Connor SR, Knighton DR, Cerra FB (1991) Preoperative optimization of cardiovascular hemodynamics improves outcome in peripheral vascular surgery: a prospective, randomized clinical trial. Ann Surg 214(3):289–297, discussion 298–289

    Article  PubMed  CAS  Google Scholar 

  69. Bender JS, Smith-Meek MA, Jones CE (1997) Routine pulmonary artery catheterization does not reduce morbidity and mortality of elective vascular surgery: results of a prospective, randomized trial. Ann Surg 226(3):229–236, discussion 236–227

    Article  PubMed  CAS  Google Scholar 

  70. Ziegler DW, Wright JG, Choban PS, Flancbaum L (1997) A prospective randomized trial of preoperative “optimization” of cardiac function in patients undergoing elective peripheral vascular surgery. Surgery 122(3):584–592

    Article  PubMed  CAS  Google Scholar 

  71. Leppo JA (1995) Preoperative cardiac risk assessment for noncardiac surgery. Am J Cardiol 75(11):42D–51D

    Article  PubMed  CAS  Google Scholar 

  72. Biagini E, Elhendy A, Schinkel AF et al (2005) Long-term prediction of mortality in elderly persons by dobutamine stress echocardiography. J Gerontol A Biol Sci Med Sci 60(10):1333–1338

    Article  PubMed  Google Scholar 

  73. Pollock M, Roa J, Benditt J, Celli B (1993) Estimation of ventilatory reserve by stair climbing: a study in patients with chronic airflow obstruction. Chest 104(5):1378–1383

    Article  PubMed  CAS  Google Scholar 

  74. Brunelli A, Refai M, Xiume F et al (2008) Performance at symptom-limited stair-climbing test is associated with increased cardiopulmonary complications, mortality, and costs after major lung resection. Ann Thorac Surg 86(1):240–247, discussion 247–248

    Article  PubMed  Google Scholar 

  75. Win T, Jackson A, Groves AM, Sharples LD, Charman SC, Laroche CM (2006) Comparison of shuttle walk with measured peak oxygen consumption in patients with operable lung cancer. Thorax 61(1):57–60

    Article  PubMed  CAS  Google Scholar 

  76. Simonsick EM, Fan E, Fleg JL (2006) Estimating cardiorespiratory fitness in well-functioning older adults: treadmill validation of the long distance corridor walk. J Am Geriatr Soc 54(1):127–132

    Article  PubMed  Google Scholar 

  77. Weinstein H, Bates AT, Spaltro BE, Thaler HT, Steingart RM (2007) Influence of preoperative exercise capacity on length of stay after thoracic cancer surgery. Ann Thorac Surg 84(1):197–202

    Article  PubMed  Google Scholar 

  78. Audisio RA, Pope D, Ramesh HS et al (2008) Shall we operate? Preoperative assessment in elderly cancer patients (PACE) can help. A SIOG surgical task force prospective study. Crit Rev Oncol Hematol 65(2):156–163

    Article  PubMed  CAS  Google Scholar 

  79. Internullo E, Moons J, Nafteux P et al (2008) Outcome after esophagectomy for cancer of the esophagus and GEJ in patients aged over 75 years. Eur J Cardiothorac Surg 33(6):1096–1104

    Article  PubMed  Google Scholar 

  80. Iwamoto K, Ichiyama S, Shimokata K, Nakashima N (1993) Postoperative pneumonia in elderly patients: incidence and ­mortality in comparison with younger patients. Intern Med 32(4):274–277

    Article  PubMed  CAS  Google Scholar 

  81. Kwon AH, Matsui Y (2006) Laparoscopic cholecystectomy in patients aged 80 years and over. World J Surg 30(7):1204–1210

    Article  PubMed  Google Scholar 

  82. Landau O, Kott I, Deutsch AA, Stelman E, Reiss R (1992) Multifactorial analysis of septic bile and septic complications in biliary surgery. World J Surg 16(5):962–964, discussion 964–965

    Article  PubMed  CAS  Google Scholar 

  83. Meijer WS, Schmitz PI, Jeekel J (1990) Meta-analysis of randomized, controlled clinical trials of antibiotic prophylaxis in biliary tract surgery. Br J Surg 77(3):283–290

    Article  PubMed  CAS  Google Scholar 

  84. Watters JM, Clancey SM, Moulton SB, Briere KM, Zhu JM (1993) Impaired recovery of strength in older patients after major abdominal surgery. Ann Surg 21(3):380–390, discussion 390–383

    Article  Google Scholar 

  85. Kudsk KA, Tolley EA, DeWitt RC et al (2003) Preoperative albumin and surgical site identify surgical risk for major postoperative complications. JPEN J Parenter Enteral Nutr 27(1):1–9

    Article  PubMed  Google Scholar 

  86. Souba WW (1997) Nutritional support. N Engl J Med 336(1):41–48

    Article  PubMed  CAS  Google Scholar 

  87. Bittner R, Butters M, Ulrich M, Uppenbrink S, Beger HG (1996) Total gastrectomy. Updated operative mortality and long-term survival with particular reference to patients older than 70 years of age. Ann Surg 224(1):37–42

    Article  PubMed  CAS  Google Scholar 

  88. Myrdal G, Gustafsson G, Lambe M, Horte LG, Stahle E (2001) Outcome after lung cancer surgery. Factors predicting early ­mortality and major morbidity. Eur J Cardiothorac Surg 20(4):694–699

    Article  PubMed  CAS  Google Scholar 

  89. Allen MS, Darling GE, Pechet TT et al (2006) Morbidity and mortality of major pulmonary resections in patients with early-stage lung cancer: initial results of the randomized, prospective ACOSOG Z0030 trial. Ann Thorac Surg 81(3):1013–1019, discussion 1019–1020

    Article  PubMed  Google Scholar 

  90. Cerfolio RJ, Bryant AS (2006) Survival and outcomes of pulmonary resection for non-small cell lung cancer in the elderly: a nested case-control study. Ann Thorac Surg 82(2):424–429, discussion 429–430

    Article  PubMed  Google Scholar 

  91. Coyle KA, Smith RB 3rd, Salam AA, Dodson TF, Chaikof EL, Lumsden AB (1994) Carotid endarterectomy in the octogenarian. Ann Vasc Surg 8(5):417–420

    Article  PubMed  CAS  Google Scholar 

  92. Maehara Y, Oshiro T, Oiwa H et al (1995) Gastric carcinoma in patients over 70 years of age. Br J Surg 82(1):102–105

    Article  PubMed  CAS  Google Scholar 

  93. Jougon JB, Ballester M, Duffy J et al (1997) Esophagectomy for cancer in the patient aged 70 years and older. Ann Thorac Surg 63(5):1423–1427

    Article  PubMed  CAS  Google Scholar 

  94. de Perrot M, Licker M, Reymond MA, Robert J, Spiliopoulos A (1999) Influence of age on operative mortality and long-term survival after lung resection for bronchogenic carcinoma. Eur Respir J 14(2):419–422

    Article  PubMed  Google Scholar 

  95. Okada M, Nishio W, Sakamoto T, Harada H, Uchino K, Tsubota N (2003) Long-term survival and prognostic factors of five-year ­survivors with complete resection of non-small cell lung carcinoma. J Thorac Cardiovasc Surg 126(2):558–562

    Article  PubMed  Google Scholar 

  96. Thomas P, Sielezenff I, Rajni J, Giridicilli R, Fuentes P (1993) Is lung cancer resection justified in patients aged over 70 years? Eur J Cardiothorac Surg 7:246–251

    Article  PubMed  CAS  Google Scholar 

  97. Turrentine FE, Wang H, Simpson VB, Jones RS (2006) Surgical risk factors, morbidity, and mortality in elderly patients. J Am Coll Surg 203(6):865–877

    Article  PubMed  Google Scholar 

  98. Keller SM, Markovitz LJ, Wilder JR, Aufses AH Jr (1987) Emergency and elective surgery in patients over age 70. Am Surg 53(11):636–640

    PubMed  CAS  Google Scholar 

  99. Bingener J, Richards ML, Schwesinger WH, Strodel WE, Sirinek KR (2003) Laparoscopic cholecystectomy for elderly patients: gold standard for golden years? Arch Surg 138(5):531–535, discussion 535–536

    Article  PubMed  Google Scholar 

  100. Tambyraja AL, Kumar S, Nixon SJ (2004) Outcome of laparoscopic cholecystectomy in patients 80 years and older. World J Surg 28(8):745–748

    Article  PubMed  Google Scholar 

  101. Tsai TP, Chaux A, Matloff JM et al (1994) Ten-year experience of cardiac surgery in patients aged 80 years and ove. Ann Thorac Surg 58(2):445–450, discussion 450–441

    Article  PubMed  CAS  Google Scholar 

  102. Tseng EE, Lee CA, Cameron DE et al (1997) Aortic valve replacement in the elderly. Risk factors and long-term results. Ann Surg 225(6):793–802, discussion 802–794

    Article  PubMed  CAS  Google Scholar 

  103. Bender JS, Magnuson TH, Zenilman ME et al (1996) Outcome following colon surgery in the octagenarian. Am Surg 62(4):276–279

    PubMed  CAS  Google Scholar 

  104. Spivak H, Maele DV, Friedman I, Nussbaum M (1996) Colorectal surgery in octogenarians. J Am Coll Surg 183(1):46–50

    PubMed  CAS  Google Scholar 

  105. Sisto D, Hoffman D, Frater RW (1993) Isolated coronary artery bypass grafting in one hundred octogenarian patients. J Thorac Cardiovasc Surg 106(5):940–942

    PubMed  CAS  Google Scholar 

  106. Logeais Y, Langanay T, Roussin R et al (1994) Surgery for aortic stenosis in elderly patients. A study of surgical risk and predictive factors. Circulation 90(6):2891–2898

    Article  PubMed  CAS  Google Scholar 

  107. Maurice-Williams RS, Kitchen ND (1992) Intracranial tumours in the elderly: the effect of age on the outcome of first time surgery for meningiomas. Br J Neurosurg 6(2):131–137

    Article  PubMed  CAS  Google Scholar 

  108. Tan KY, Chen CM, Ng C, Tan SM, Tay KH (2006) Which octogenarians do poorly after major open abdominal surgery in our Asian population? World J Surg 30(4):547–552

    Article  PubMed  Google Scholar 

  109. Adam DJ, Craig SR, Sang CT, Cameron EW, Walker WS (1996) Esophagectomy for carcinoma in the octogenarian. Ann Thorac Surg 61(1):190–194

    Article  PubMed  CAS  Google Scholar 

  110. Mathisen DJ, Grillo HC, Wilkins EW Jr, Moncure AC, Hilgenberg AD (1988) Transthoracic esophagectomy: a safe approach to carcinoma of the esophagus. Ann Thorac Surg 45(2):137–143

    Article  PubMed  CAS  Google Scholar 

  111. Bandoh T, Isoyama T, Toyoshima H (1991) Total gastrectomy for gastric cancer in the elderly. Surgery 109(2):136–142

    PubMed  CAS  Google Scholar 

  112. Katz NM, Chase GA (1997) Risks of cardiac operations for elderly patients: reduction of the age factor. Ann Thorac Surg 63(5):1309–1314

    Article  PubMed  CAS  Google Scholar 

  113. Bernstein EF, Dilley RB, Randolph HF 3rd (1988) The improving long-term outlook for patients over 70 years of age with abdominal aortic aneurysms. Ann Surg 207(3):318–322

    Article  PubMed  CAS  Google Scholar 

  114. Lo CY, van Heerden JA, Grant CS, Soreide JA, Warner MA, Ilstrup DM (1996) Adrenal surgery in the elderly: too risky? World J Surg 20(3):368–373, discussion 374

    Article  PubMed  CAS  Google Scholar 

  115. Giannice R, Foti E, Poerio A, Marana E, Mancuso S, Scambia G (2004) Perioperative morbidity and mortality in elderly gynecological oncological patients (≥70 years) by the American Society of Anesthesiologists Physical Status classes. Ann Surg Oncol 11(2):219–225

    Article  PubMed  Google Scholar 

  116. Social Security Online (2000) Period life table, 2000. Statistical tables. http://www.ssa.gov/OACT/STATS/table4c6.html. Actuarial Publications, Baltimore, MD. Accessed 8 Mar 2004

  117. Minino AM, Heron MP, Smith BL (2006) Deaths: preliminary data for 2004. Natl Vital Stat Rep 54(19):1–49

    Google Scholar 

  118. Nugent WC, Edney MT, Hammerness PG, Dain BJ, Maurer LH, Rigas JR (1997) Non-small cell lung cancer at the extremes of age: impact on diagnosis and treatment. Ann Thorac Surg 63(1):193–197

    Article  PubMed  CAS  Google Scholar 

  119. Kuo CW, Chen YM, Chao JY, Tsai CM, Perng RP (2000) Non-small cell lung cancer in very young and very old patients. Chest 117(2):354–357

    Article  PubMed  CAS  Google Scholar 

  120. Fruh M, Rolland E, Pignon JP et al (2008) Pooled analysis of the effect of age on adjuvant cisplatin-based chemotherapy for completely resected non-small-cell lung cancer. J Clin Oncol 26(21):3573–3581

    Article  PubMed  CAS  Google Scholar 

  121. Cress RD, O’Malley CD, Leiserowitz GS, Campleman SL (2003) Patterns of chemotherapy use for women with ovarian cancer: a population-based study. J Clin Oncol 21(8):1530–1535

    Article  PubMed  Google Scholar 

  122. Moore DH (1994) Ovarian cancer in the elderly patient. Oncology (Huntingt) 8(12):21–25, discussion 25, 29–30

    CAS  Google Scholar 

  123. Edmonson JH, Su J, Krook JE (1993) Treatment of ovarian cancer in elderly women. Mayo Clinic-North Central Cancer Treatment Group studies. Cancer 71(2 Suppl):615–617

    PubMed  CAS  Google Scholar 

  124. Singletary SE, Shallenberger R, Guinee VF (1993) Breast cancer in the elderly. Ann Surg 218(5):667–671

    Article  PubMed  CAS  Google Scholar 

  125. Wanebo HJ, Cole B, Chung M et al (1997) Is surgical management compromised in elderly patients with breast cancer? Ann Surg 225(5):579–586, discussion 586–579

    Article  PubMed  CAS  Google Scholar 

  126. Swanson RS, Sawicka J, Wood WC (1991) Treatment of carcinoma of the breast in the older geriatric patient. Surg Gynecol Obstet 173(6):465–469

    PubMed  CAS  Google Scholar 

  127. van Dalsen AD, de Vries JE (1995) Treatment of breast cancer in elderly patients. J Surg Oncol 60(2):80–82

    Article  PubMed  Google Scholar 

  128. Guadagnoli E, Shapiro C, Gurwitz JH et al (1997) Age-related patterns of care: evidence against ageism in the treatment of early-stage breast cancer. J Clin Oncol 15(6):2338–2344

    PubMed  CAS  Google Scholar 

  129. Hebert-Croteau N, Brisson J, Latreille J, Blanchette C, Deschenes L (1999) Compliance with consensus recommendations for the treatment of early stage breast carcinoma in elderly women. Cancer 85(5):1104–1113

    Article  PubMed  CAS  Google Scholar 

  130. Hurria A, Hurria A, Zuckerman E et al (2006) A prospective, longitudinal study of the functional status and quality of life of older patients with breast cancer receiving adjuvant chemotherapy. J Am Geriatr Soc 54(7):1119–1124

    Article  PubMed  Google Scholar 

  131. Silliman RA, Ganz PA (2006) Adjuvant chemotherapy use and outcomes in older women with breast cancer: what have we learned? J Clin Oncol 24(18):2697–2699

    Article  PubMed  Google Scholar 

  132. Bilimoria KY, Stewart AK, Palis BE, Bentrem DJ, Talamonti MS, Ko CY (2008) Adequacy and importance of lymph node evaluation for colon cancer in the elderly. J Am Coll Surg 206(2):247–254

    Article  PubMed  Google Scholar 

  133. Chalmers RT, Stonebridge PA, John TG, Murie JA (1993) Abdominal aortic aneurysm in the elderly. Br J Surg 80(9):1122–1123

    Article  PubMed  CAS  Google Scholar 

  134. Blanche C, Matloff JM, Denton TA et al (1997) Cardiac operations in patients 90 years of age and older. Ann Thorac Surg 63(6):1685–1690

    Article  PubMed  CAS  Google Scholar 

  135. Finlayson E, Fan Z, Birkmeyer JD (2007) Outcomes in octogenarians undergoing high-risk cancer operation: a national study. J Am Coll Surg 205(6):729–734

    Article  PubMed  Google Scholar 

  136. Moskovitz AH, Rizk NP, Venkatraman E et al (2006) Mortality increases for octogenarians undergoing esophagogastrectomy for esophageal cancer. Ann Thorac Surg 82(6):2031–2036, discussion 2036

    Article  PubMed  Google Scholar 

  137. Ngaage DL, Cowen ME, Griffin S, Guvendik L, Cale AR (2008) Early neurological complications after coronary artery bypass grafting and valve surgery in octogenarians. Eur J Cardiothorac Surg 33(4):653–659

    Article  PubMed  Google Scholar 

  138. Leo F, Scanagatta P, Baglio P et al (2007) The risk of pneumonectomy over the age of 70. A case-control study. Eur J Cardiothorac Surg 31(5):780–782

    Article  PubMed  Google Scholar 

  139. Barnett SD, Halpin LS, Speir AM et al (2003) Postoperative complications among octogenarians after cardiovascular surgery. Ann Thorac Surg 76(3):726–731

    Article  PubMed  Google Scholar 

  140. Jarvinen O, Huhtala H, Laurikka J, Tarkka MR (2003) Higher age predicts adverse outcome and readmission after coronary artery bypass grafting. World J Surg 27(12):1317–1322

    Article  PubMed  Google Scholar 

  141. Lightner AM, Glasgow RE, Jordan TH et al (2004) Pancreatic resection in the elderly. J Am Coll Surg 198(5):697–706

    Article  PubMed  Google Scholar 

  142. Sosa JA, Mehta PJ, Wang TS, Boudourakis L, Roman SA (2008) A population-based study of outcomes from thyroidectomy in aging Americans: at what cost? J Am Coll Surg 206(3):1097–1105

    Article  PubMed  Google Scholar 

  143. Mamoun NF, Xu M, Sessler DI, Sabik JF, Bashour CA (2008) Propensity matched comparison of outcomes in older and younger patients after coronary artery bypass graft surgery. Ann Thorac Surg 85(6):1974–1979

    Article  PubMed  Google Scholar 

  144. Fraioli B, Pastore FS, Signoretti S, De Caro GM, Giuffre R (1999) The surgical treatment of pituitary adenomas in the eighth decade. Surg Neurol 51(3):261–266, discussion 266–267

    Article  PubMed  CAS  Google Scholar 

  145. Derks W, De Leeuw JR, Hordijk GJ, Winnubst JA (2003) Elderly patients with head and neck cancer: short-term effects of surgical treatment on quality of life. Clin Otolaryngol 28(5):399–405

    Article  PubMed  CAS  Google Scholar 

  146. Uruno T, Miyauchi A, Shimizu K et al (2005) Favorable surgical results in 433 elderly patients with papillary thyroid cancer. World J Surg 29(11):1497–1501, discussion 1502–1493

    Article  PubMed  Google Scholar 

  147. Salameh JR, Myers JL, Mukherjee D (200) Carotid endarterectomy in elderly patients: low complication rate with overnight stay. Arch Surg 137(11):1284–1287, discussion 1288

    Article  Google Scholar 

  148. Durward QJ, Ragnarsson TS, Reeder RF, Case JL, Hughes CA (2005) Carotid endarterectomy in nonagenarians. Arch Surg 140(7):625–628, discussion 628

    Article  PubMed  Google Scholar 

  149. Beauford RB, Goldstein DJ, Sardari FF et al (2003) Multivessel off-pump revascularization in octogenarians: early and midterm outcomes. Ann Thorac Surg 76(1):12–17, discussion 17

    Article  PubMed  Google Scholar 

  150. Chiappini B, Camurri N, Loforte A, Di Marco L, Di Bartolomeo R, Marinelli G (2004) Outcome after aortic valve replacement in octogenarians. Ann Thorac Surg 78(1):85–89

    Article  PubMed  Google Scholar 

  151. Collart F, Feier H, Kerbaul F et al (2005) Valvular surgery in octogenarians: operative risks factors, evaluation of Euroscore and long term results. Eur J Cardiothorac Surg 27(2):276–280

    Article  PubMed  Google Scholar 

  152. Ferguson TB Jr, Hammill BG, Peterson ED, DeLong ER, Grover FL (2002) A decade of change–risk profiles and outcomes for isolated coronary artery bypass grafting procedures, 1990–1999: a report from the STS National Database Committee and the Duke Clinical Research Institute. Society of Thoracic Surgeons. Ann Thorac Surg 73(2):480–489, discussion 489–490

    Article  PubMed  Google Scholar 

  153. Huber CH, Goeber V, Berdat P, Carrel T, Eckstein F (2007) Benefits of cardiac surgery in octogenarians – a postoperative quality of life assessment. Eur J Cardiothorac Surg 31(6):1099–1105

    Article  PubMed  Google Scholar 

  154. Rice DC, Correa AM, Vaporciyan AA et al (2005) Preoperative chemoradiotherapy prior to esophagectomy in elderly patients is not associated with increased morbidity. Ann Thorac Surg 79(2):391–397, discussion 391–397

    Article  PubMed  Google Scholar 

  155. Ruol A, Portale G, Zaninotto G et al (2007) Results of esophagectomy for esophageal cancer in elderly patients: age has little influence on outcome and survival. J Thorac Cardiovasc Surg 133(5):1186–1192

    Article  PubMed  Google Scholar 

  156. Ruol A, Portale G, Castoro C et al (2007) Effects of neoadjuvant therapy on perioperative morbidity in elderly patients undergoing esophagectomy for esophageal cancer. Ann Surg Oncol 14(11):3243–3250

    Article  PubMed  Google Scholar 

  157. Poon RT, Law SY, Chu KM, Branicki FJ, Wong J (1998) Esophagectomy for carcinoma of the esophagus in the elderly: results of current surgical management. Ann Surg 227(3):357–364

    Article  PubMed  CAS  Google Scholar 

  158. Kunisaki C, Akiyama H, Nomura M et al (2006) Comparison of surgical outcomes of gastric cancer in elderly and middle-aged patients. Am J Surg 191(2):216–224

    Article  PubMed  Google Scholar 

  159. Avital S, Kashtan H, Hadad R, Werbin N (1997) Survival of colorectal carcinoma in the elderly. A prospective study of colorectal carcinoma and a five-year follow-up. Dis Colon Rectum 40(5):523–529

    Article  PubMed  CAS  Google Scholar 

  160. Barrier A, Ferro L, Houry S, Lacaine F, Huguier M (2003) Rectal cancer surgery in patients more than 80 years of age. Am J Surg 185(1):54–57

    Article  PubMed  Google Scholar 

  161. Law WL, Choi HK, Ho JW, Lee YM, Seto CL (2006) Outcomes of surgery for mid and distal rectal cancer in the elderly. World J Surg 30(4):598–604

    Article  PubMed  Google Scholar 

  162. Aldrighetti L, Arru M, Caterini R et al (2003) Impact of advanced age on the outcome of liver resection. World J Surg 27(10):1149–1154

    Article  PubMed  Google Scholar 

  163. Cescon M, Grazi GL, Del Gaudio M et al (2003) Outcome of right hepatectomies in patients older than 70 years. Arch Surg 138(5):547–552

    Article  PubMed  Google Scholar 

  164. Ferrero A, Vigano L, Polastri R et al (2005) Hepatectomy as treatment of choice for hepatocellular carcinoma in elderly cirrhotic patients. World J Surg 29(9):1101–1105

    Article  PubMed  Google Scholar 

  165. Menon KV, Al-Mukhtar A, Aldouri A, Prasad RK, Lodge PA, Toogood GJ (2006) Outcomes after major hepatectomy in elderly patients. J Am Coll Surg 203(5):677–683

    Article  PubMed  Google Scholar 

  166. Sohn TA, Yeo CJ, Cameron JL et al (1998) Should pancreaticoduodenectomy be performed in octogenarians? J Gastrointest Surg 2(3):207–216

    Article  PubMed  CAS  Google Scholar 

  167. Petrowsky H, Clavien PA (2005) Should we deny surgery for malignant hepato-pancreatico-biliary tumors to elderly patients? World J Surg 29(9):1093–1100

    Article  PubMed  Google Scholar 

  168. Geisler JP, Geisler HE (1994) Radical hysterectomy in patients 65 years of age and older. Gynecol Oncol 53(2):208–211

    Article  PubMed  CAS  Google Scholar 

  169. Anderson JG, Wixson RL, Tsai D, Stulberg SD, Chang RW (1996) Functional outcome and patient satisfaction in total knee patients over the age of 75. J Arthroplasty 11(7):831–840

    Article  PubMed  CAS  Google Scholar 

  170. Wurtz LD, Feinberg JR, Capello WN, Meldrum R, Kay PJ (2003) Elective primary total hip arthroplasty in octogenarians. J Gerontol A Biol Sci Med Sci 58(5):M468–M471

    Article  PubMed  Google Scholar 

  171. Hamel MB, Toth M, Legedza A, Rosen MP (2008) Joint replacement surgery in elderly patients with severe osteoarthritis of the hip or knee: decision making, postoperative recovery, and clinical outcomes. Arch Intern Med 168(13):1430–1440

    Article  PubMed  Google Scholar 

  172. Malata CM, Cooter RD, Batchelor AG, Simpson KH, Browning FS, Kay SP (1996) Microvascular free-tissue transfers in elderly patients: the leeds experience. Plast Reconstr Surg 98(7):1234–1241

    Article  PubMed  CAS  Google Scholar 

  173. Morgan JA, John R, Weinberg AD et al (2003) Long-term results of cardiac transplantation in patients 65 years of age and older: a comparative analysis. Ann Thorac Surg 76(6):1982–1987

    Article  PubMed  Google Scholar 

  174. Mahidhara R, Bastani S, Ross DJ et al (2008) Lung transplantation in older patients? J Thorac Cardiovasc Surg 135(2):412–420

    Article  PubMed  Google Scholar 

  175. Minor ME, Ellozy S, Carroccio A et al (2004) Endovascular aortic aneurysm repair in the octogenarian: is it worthwhile? Arch Surg 139(3):308–314

    Article  PubMed  Google Scholar 

  176. St Peter SD, Craft RO, Tiede JL, Swain JM (2005) Impact of advanced age on weight loss and health benefits after laparoscopic gastric bypass. Arch Surg 140(2):165–168

    Article  PubMed  Google Scholar 

  177. Chautard J, Alves A, Zalinski S, Bretagnol F, Valleur P, Panis Y (2008) Laparoscopic colorectal surgery in elderly patients: a matched case-control study in 178 patients. J Am Coll Surg 206(2):255–260

    Article  PubMed  Google Scholar 

  178. Gianetta E, de Cian F, Cuneo S et al (1997) Hernia repair in elderly patients. Br J Surg 84(7):983–985

    Article  PubMed  CAS  Google Scholar 

  179. Amemiya T, Oda K, Ando M et al (2007) Activities of daily living and quality of life of elderly patients after elective surgery for gastric and colorectal cancers. Ann Surg 246(2):222–228

    Article  PubMed  Google Scholar 

  180. Zierer A, Melby SJ, Lubahn JG, Sicard GA, Damiano RJ Jr, Moon MR (2006) Elective surgery for thoracic aortic aneurysms: late functional status and quality of life. Ann Thorac Surg 82(2):573–578

    Article  PubMed  Google Scholar 

  181. de Vincentiis C, Kunkl AB, Trimarchi S et al (2008) Aortic valve replacement in octogenarians: is biologic valve the unique solution? Ann Thorac Surg 85(4):1296–1301

    Article  PubMed  Google Scholar 

  182. Vicchio M, Della Corte A, De Santo LS et al (2008) Tissue versus mechanical prostheses: quality of life in octogenarians. Ann Thorac Surg 85(4):1290–1295

    Article  PubMed  Google Scholar 

  183. Dunlop WE, Rosenblood L, Lawrason L, Birdsall L, Rusnak CH (1993) Effects of age and severity of illness on outcome and length of stay in geriatric surgical patients. Am J Surg 165(5):577–580

    Article  PubMed  CAS  Google Scholar 

  184. Akoh JA, Mathew AM, Chalmers JW, Finlayson A, Auld GD (1994) Audit of major gastrointestinal surgery in patients aged 80 years or over. J R Coll Surg Edinb 39(4):208–213

    PubMed  CAS  Google Scholar 

  185. Battafarano RJ, Piccirillo JF, Meyers BF et al (2002) Impact of comorbidity on survival after surgical resection in patients with stage I non-small cell lung cancer. J Thorac Cardiovasc Surg 123(2):280–287

    Article  PubMed  Google Scholar 

  186. Mehta RH, Eagle KA, Coombs LP et al (2002) Influence of age on outcomes in patients undergoing mitral valve replacement. Ann Thorac Surg 74(5):1459–1467

    Article  PubMed  Google Scholar 

  187. Muravchick S (2000) Anesthesia for the elderly. In: Miller RD (ed) Anesthesia, 5th edn. Churchill Livingston, Philadelphia, pp 2140–2156

    Google Scholar 

  188. Barzan L, Veronesi A, Caruso G et al (1990) Head and neck cancer and ageing: a retrospective study in 438 patients. J Laryngol Otol 104(8):634–640

    Article  PubMed  CAS  Google Scholar 

  189. Gupta R, Kawashima T, Ryu M, Okada T, Cho A, Takayama W (2004) Role of curative resection in octogenarians with malignancy. Am J Surg 188(3):282–287

    Article  PubMed  Google Scholar 

  190. Martin RC II, Jaques DP, Brennan MF, Karpeh M (2002) Extended local resection for advanced gastric cancer: increased survival versus increased morbidity. Ann Surg 236(2):159–165

    Article  PubMed  Google Scholar 

  191. Siegelmann-Danieli N, Khandelwal V, Wood GC et al (2006) Breast cancer in elderly women: outcome as affected by age, tumor features, comorbidities, and treatment approach. Clin Breast Cancer 7(1):59–66

    Article  PubMed  Google Scholar 

  192. Muravchick S (2000) Anesthesia for the elderly. In: Miller R (ed) Anesthesia, 5th edn. Churchill Livingstone, Philadelphia, pp 2140–2156

    Google Scholar 

  193. Lakatta EG (1994) Cardiovascular reserve capacity in healthy older humans. Aging (Milano) 6(4):213–223

    CAS  Google Scholar 

  194. Muravchick S (1997) Choosing an anesthetic for the elderly patient. Am Rev PAN 19:117–124

    Google Scholar 

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Katlic, M.R. (2011). Principles of Geriatric Surgery. In: Rosenthal, R., Zenilman, M., Katlic, M. (eds) Principles and Practice of Geriatric Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-6999-6_20

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