Surgical Approaches to the Geriatric Patient

  • Ronnie Ann Rosenthal
Chapter

Keywords

Wound Healing Acute Cholecystitis Geriatric Patient Open Cholecystectomy National Surgical Quality Improvement Program 
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References

  1. 1.
    Warner MA, Saletel RA, Schroeder DR, et al. Outcome of anesthesia and surgery in people 100 years of age and older. J Am Geriatr Soc. 1998;46:988–993.PubMedGoogle Scholar
  2. 2.
    Centers for Disease Control and Prevention. Advanced Data no. 316. Washington, DC: National Center for Health Statistics; June 30, 2000.Google Scholar
  3. 3.
    Farrow DC, Hunt WC, Samet JM. Temporal and regional variability in the surgical treatment of cancer among older people. J Am Geriatr Soc. 1996;44:559–564.PubMedGoogle Scholar
  4. 4.
    Sollano JA, Rose EA, Williams DL, et al. Cost-effectiveness of coronary artery bypass surgery in octogenarians. Ann Surg. 1998;228:297–306.PubMedCrossRefGoogle Scholar
  5. 5.
    Kind P. Measuring valuations for health states. A survey of patients in general practice. Discussion paper 76. York: Center for Health Economics, University of York; 1990.Google Scholar
  6. 6.
    Thomas DR, Ritchie CS. Preoperative assessment of older adults. J Am Geriatr Soc. 1995;43:811–821.PubMedGoogle Scholar
  7. 7.
    Khuri SF, Daley J, Henderson W, et al. The National Veterans Administration Surgical Risk Study: risk adjustment for the comparative assessment of the quality of surgical care. J Am Coll Surg. 1995;180:519–531.PubMedGoogle Scholar
  8. 8.
    Khuri SF, Daley J, Henderson W. National Surgical Quality Improvement Program (NSQIP). Annual Report; Hines, IL: Department of Veteran Affairs, FY 1999;A-5.Google Scholar
  9. 9.
    Escarce JJ, Shea JA, Chen W, et al. Outcomes of open cholecystectomy in the elderly: a longitudinal analysis of 21,000 cases in the prelaparoscopic era. Surgery. 1995;117:156.PubMedGoogle Scholar
  10. 10.
    Buxbaum JL, Schwartz AJ. Perianesthetic considerations for the elderly patient. Surg Clin North Am. 1994;74:41–61.PubMedGoogle Scholar
  11. 11.
    Djokovic JL, Hedley-White J. Prediction of outcome of surgery and anesthesia in patients over 80. JAMA. 1979;242:2301–2304.PubMedCrossRefGoogle Scholar
  12. 12.
    Khuri SF, Daley J, Henderson W, et al. Department of Veterans Affairs’ NSQIP. The first national, validated, outcome-based, risk adjusted, and peer-controlled program for the measurement and enhancement of the quality of surgical care. Ann Surg. 1998;228:491–507.PubMedCrossRefGoogle Scholar
  13. 13.
    Narain P, Rubenstein LZ, Wieland GD, et al. Predictors of immediate and 6 month outcome in hospitalized elderly patients. The importance of functional status. J Am Geriatr Soc. 1988;36:775–783.PubMedGoogle Scholar
  14. 14.
    Seymour DG, Pringle R. Post-operative complications in the elderly surgical patient. Gerontology. 1983;29:262–270.PubMedCrossRefGoogle Scholar
  15. 15.
    Browner WS, Manganese DT. In hospital and long-term mortality in male veterans following non-cardiac surgery: The study of perioperative ischemia research group. JAMA. 1992;268:228–232.PubMedCrossRefGoogle Scholar
  16. 16.
    Shahar A, Powers KA, Black JS. The risk of postoperative deconditioning in older adults. J Am Geriatr Soc. 1996; 44:471–474.PubMedGoogle Scholar
  17. 17.
    Gerson MC, Hurst JM, Hertzberg VS, et al. Cardiac prognosis in noncardiac geriatric surgery. Ann Intern Med. 1985;103:832–837.PubMedGoogle Scholar
  18. 18.
    Gerson MC, Hurst JM, Hertzberg VS, et al. Prediction of cardiac and pulmonary complications related to elective abdominal and noncardiac thoracic surgery in geriatric patients. Am J Med. 1990;88:101–107.PubMedCrossRefGoogle Scholar
  19. 19.
    Older P, Smith R, Courtney P, et al. Preoperative evaluation of cardiac function and ischemia in elderly patients by cardiopulmonary exercise testing. Chest. 1993;103:701–705.Google Scholar
  20. 20.
    Eagle KA, Brundage BH, Chaitman BR, et al. ACC/AHA Task Force Report: guidelines for perioperative cardiovascular evaluation for noncardiac surgery. Circulation. 1996;93:1278–1317.PubMedGoogle Scholar
  21. 21.
    Hlatky MA, Boineau BE, Higginbotham MB, et al. A brief self-administered questionnaire to determine functional capacity (the Duke’s Activity Status Index). Am J Cardiol. 1989;64:651–656.PubMedCrossRefGoogle Scholar
  22. 22.
    Reuben DB, Greendale GA, Harrison GG. Nutrition screening in older persons. J Am Geriatr Soc. 1995;43:415–420.PubMedGoogle Scholar
  23. 23.
    Rosenberg IH. Nutrition and aging. In: Hazzard WR, Bierman EL, Blass JP, et al, eds. Principles of Geriatric Medicine and Gerontology, 3rd Ed. New York: McGraw-Hill; 1994:49–60.Google Scholar
  24. 24.
    Detsky AS, Mclaughlin JR, Baker JP, et al. What is subjective global assessment of nutritional status? J Parenter Enteral Nutr. 1987;11:8–13.Google Scholar
  25. 25.
    Detsky AS, et al. Predicting nutrition-associated complications for patients undergoing gastrointestinal surgery. J Parenter Enteral Nutr. 1987;11:440–446.Google Scholar
  26. 26.
    Lipschitz DA. Nutrition. In: Cassel CK, Cohen HJ, Larson EB, et al. eds. Geriatric Medicine, 3rd Ed. New York: Springer-Verlag; 1996:801–813.Google Scholar
  27. 27.
    Cheng ATH, Planck LD, Hill GL. Prolonged overexpansion of the extracellular water in elderly patients with sepsis. Arch Surg. 1998;133:745–751.PubMedCrossRefGoogle Scholar
  28. 28.
    Gibbs J, Cull W, Henderson W, et al. Preoperative serum albumin level as a predictor of operative mortality and morbidity. Arch Surg. 1999;134:36–42.PubMedCrossRefGoogle Scholar
  29. 29.
    Marcantonio ER, Goldman L, Mangione CM, et al. A clinical prediction rule for delirium after elective noncardiac surgery. JAMA. 1994;271(2):134–139.PubMedCrossRefGoogle Scholar
  30. 30.
    Moller JT, Cluitmans P, Rasmussen LS, et al. Long-term postoperative cognitive dysfunction in the elderly: ISPOCD1 study. Lancet. 1998;351:857–861.PubMedCrossRefGoogle Scholar
  31. 31.
    Newmann MF, Kirchner JL, Phillips-Bute B, et al. Longitudinal assessment of neurocognitive function after coronary-artery bypass surgery. N Engl J Med. 2001;344: 395–401.CrossRefGoogle Scholar
  32. 32.
    Williams-Russo P, Urquhart BL, Sharrock NE, et al. Post-operative delirium: predictors and prognosis in elderly orthopedic patients. J Am Geriatr Soc. 1992;40:759–777.PubMedGoogle Scholar
  33. 33.
    Marcantonio ER, Goldman L, Orav JE, Cook FE, Lee TH. The association of intraoperative factors with the development of postoperative delirium. Am J Med. 1998;105(5): 380–387.PubMedCrossRefGoogle Scholar
  34. 34.
    Kaneko T, Takahashi S, Naka T, et al. Postoperative delirium following gastrointestinal surgery in elderly patients. Surg Today. 1997;27(2):107–110.PubMedCrossRefGoogle Scholar
  35. 35.
    Inouye SK, Charpentier PA. Precipitating factors for delirium in hospitalized elderly persons. Predictive model and inter-relationship with baseline vulnerability. JAMA. 1996;275:852–857.PubMedCrossRefGoogle Scholar
  36. 36.
    Inouye SK, Bogardu ST, Baker DI, et al. The hospital elder life program: a model of care to prevent cognitive and functional decline in older hospitalized patients. J Am Geriatr Soc. 2000;48:1697–1706.PubMedGoogle Scholar
  37. 37.
    Fedarko NS, Shapiro JR. Physiologic changes in the soft tissue and bone as a function of age. In: Rosenthal RA, Zenilman ME, Katlic MR, eds. Principles and Practice of Geriatric Surgery. New York: Springer-Verlag; 2000:850–866.Google Scholar
  38. 38.
    Phillips LG. Wound healing. In: Townsend CM, et al, eds. Sabiston Textbook of Surgery, 16th Ed. Philadelphia: Saunders; 2000:131–144.Google Scholar
  39. 39.
    Jacobs DO, Lara TM. Nutrition, metabolism and wound healing in the elderly. In: Rosenthal RA, Zenilman ME, Katlic MR, eds. Principles and Practice of Geriatric Surgery. New York: Springer-Verlag; 2000:65–87.Google Scholar
  40. 40.
    Ashcroft GS, Horan MA, Ferguson MWJ. Aging alters the inflammatory and endothelial cell adhesion profiles during human cutaneous wound healing. Lab Investig. 1998;78: 47–58.PubMedGoogle Scholar
  41. 41.
    Ashcroft GS, Horan MA, Ferguson MWJ. Aging is associated with reduced deposition of specific extracellular matrix components, and upregulation of angiogenesis and an altered inflammatory response in murine incisional wound healing model. J Investig Dermatol. 1997;108:430–437.PubMedCrossRefGoogle Scholar
  42. 42.
    Cohen BJ, Danon D, Roth GS. Wound repair in mice as influenced by age and anti-macrophage serum. Gerontol. 1987;42:295–301.Google Scholar
  43. 43.
    Marcus JR, Tyrone JW, Bonomo S, et al. Cellular mechanisms for diminished scarring with aging. Plast Reconstr Surg. 2000;105:1591–1599.PubMedCrossRefGoogle Scholar
  44. 44.
    Danon D, Kowatch MA, Roth GS. Promotion of wound repair in old mice by local injection of macrophages. Proc Natl Acad Sci USA. 1989;86:2018–2020.PubMedGoogle Scholar
  45. 45.
    Rattan SI, Derventzi A. Altered cellular responsiveness during ageing. Bioessays. 1991;13:601–606.PubMedCrossRefGoogle Scholar
  46. 46.
    Phillips PD, Kaji K, Cristofalo VJ. Progressive loss of proliferative response of senescing WI-38 cells to platelet derived growth factors, epidermal growth factor, insulin, transferrin, and dexamethasone. J Gerontol. 1984;39:11–17.PubMedGoogle Scholar
  47. 47.
    Holt DR, Kirk SJ, Regan MC, et al. Effect of age on wound healing in healthy human beings. Surgery. 1992;112:293–298.PubMedGoogle Scholar
  48. 48.
    Grove GL, Kligman AM. Age-associated changes in human epidermal cell renewal. J Gerontol. 1983;38:137–142.PubMedGoogle Scholar
  49. 49.
    Holm-Pedersen P, Zederfeldt B. Strength development in skin incisions in young and old rats. Scand J Plast Reconstr Surg. 1971;5:7–12.PubMedGoogle Scholar
  50. 50.
    Stoop MJ, Dirksen R, Hendriks T. Advanced age alone does not suppress healing in the intestines. Surgery. 1996;119:15–19.PubMedGoogle Scholar
  51. 51.
    Jonsson K, Jensen JA, Goodson WH, et al. Tissue oxy-genation, anemia, and perfusion in relation to wound healing in surgical patients. Ann Surg. 1991;214:605–613.PubMedGoogle Scholar
  52. 52.
    Whitney JA, Heitkemper MM. Modifying perfusion, nutrition and stress to promote wound healing in patients with acute wounds. Heart Lung. 1999;28:123–133.PubMedCrossRefGoogle Scholar
  53. 53.
    Knighton DR, Sliver IA, Hunt TK. Regulation of wound healing angiogensis-effect of oxygen gradients and inspired oxygen concentration. Surgery. 1981;90:262–269.PubMedGoogle Scholar
  54. 54.
    Pai MP, Hunt TK. Effect of varying oxygen tensions on healing of open wounds. Surg Gynecol Obstet. 1972;135: 756–758.PubMedGoogle Scholar
  55. 55.
    Quirina A, Viidik A. The influence of age on the healing of normal and ischemic incisional skin wounds. Mech Ageing Dev. 1991;58:221–232.CrossRefGoogle Scholar
  56. 56.
    Hohn DC, Mackay RD, Halliday BJ, Hunt TK. Effect of O2 tension on microbial function of leukocytes and wounds and in vitro. Surg Forum. 1976;27:18–20.PubMedGoogle Scholar
  57. 57.
    Hopf HW, Hunt TK, West JA, et al. Wound tissue oxygen predicts the risk of wound infection in surgical patients. Arch Surg. 1997;132:997–1004.PubMedGoogle Scholar
  58. 58.
    Thornton FJ, Ahrendt GM, Schaffer MR, et al. Sepsis impairs anastamotic collagen gene expression and synthesis: a possible role for nitric oxide. J Surg Res. 1997;69: 81–86.PubMedCrossRefGoogle Scholar
  59. 59.
    Bentzen A, Vejlagaard R. Asymptomatic bacteriuria in the elderly subject. Dan Med Bull. 1980;27:101–105.PubMedGoogle Scholar
  60. 60.
    Hartmann M, Jonsson K, Zederfeldt B. Effects of tissue erfusion and oxygenation on the accumulation of collagen in healing wounds. Eur J Surg. 1992;158:521–526.PubMedGoogle Scholar
  61. 61.
    Rosenthal RA, Zenilman ME. Surgery in the elderly. In: Townsend CM, et al, eds. Sabiston Textbook of Surgery, 16th ed. Philadelphia: Saunders; 2000:226–246.Google Scholar
  62. 62.
    Kurtz A, Sessler DI, Rainer L. Perioperative normothermia to reduce the incidence of surgical wound infection and shorten hospitalization. N Engl J Med. 1996;334: 1209–1215.CrossRefGoogle Scholar
  63. 63.
    Frank SM, Fleisher LA, Breslow MJ, et al. Perioperative maintenance of normothermia reduces the incidence of morbid cardiac events: a randomized clinical trial. JAMA. 1997;277:1127–1134.PubMedCrossRefGoogle Scholar
  64. 64.
    Perler BA, Christopherson R, Rosenfeld BA, et al. The influence of anethestic method on infringuinal graft patency: a closer look. Amer Surg. 1995;61:784–789.Google Scholar
  65. 65.
    Chang N, Goodson WH, Gottrup F, Hunt TK. Direct mea-surement of wound and tissue oxygen tension in postoperative patients. Ann Surg. 1983;197:470–478.PubMedGoogle Scholar
  66. 66.
    Haydock DA, Hill GL. Impaired wound healing in surgical patients with varying degrees of malnutrition. J Parenter Enteral Nutr. 1986;10:150–154.Google Scholar
  67. 67.
    Beattie AH, Prach AT, Baxter JP, Pennington CR. A randomized controlled trial evaluating the use of enteral nutritional supplements postoperatively in malnourished surgical patients. Gut. 2000;46:813–818.PubMedCrossRefGoogle Scholar
  68. 68.
    MacFie J, Woodcock NP, Palmer MD, et al. Oral dietary supplement in pre-and postoperative surgical patients: a prospective randomized clinical trial. Nutrition. 2000;16:723–728.PubMedCrossRefGoogle Scholar
  69. 69.
    Haydock DA, Hill GL. Improved wound healing response in surgical patients receiving intravenous nutrition. Br J Surg. 1987;74:320–323.PubMedGoogle Scholar
  70. 70.
    Windsor JA, Knight GS, Hill GS. Wound healing response in surgical patients: recent food intake is more important than nutritional status. Br J Surg. 1988;75:135–137.PubMedGoogle Scholar
  71. 71.
    Barbul A, Rettura G, Leveson S, et al. Wound healing and thymotrophic effects of arginine; a pituitary mechanism of action. Am J Clin Nutr. 1983;37:786–794.PubMedGoogle Scholar
  72. 72.
    Barbul A, Lazarou SA, Efron DT, et al. Arginine enhances wound healing and lymphocyte immune responses in humans. Surgery. 1990; 108:331–337.PubMedGoogle Scholar
  73. 73.
    Hurson M, Regan MC, Kirk SJ, et al. Metabolic effects of arginine in a healthy elderly population. J Parenter Enteral Nutr. 1995;19:227–230.CrossRefGoogle Scholar
  74. 74.
    Barbul A. Role of the immune system. In: Cohen IK, Diegelmann RF, Lindblad WJ, eds. Wound Healing: Biochemical and Clinical Aspects. Philadelphia: Saunders; 1992:282–291.Google Scholar
  75. 75.
    Schaffer MR, Tantry U, Ahrendt GM, et al. Acute protein-calorie malnutrition impairs wound healing: a possible role of decreased wound nitric oxide synthesis. J Am Coll Surg. 1997; 184:37–43.PubMedGoogle Scholar
  76. 76.
    Belcher HJRC, Ellis H. Somatropin and wound healing after injury. J Clin Endocrinol Metab. 1990;70:939–943.PubMedCrossRefGoogle Scholar
  77. 77.
    Christensen H, Oxlund H. Growth hormone increases the collagen deposition rate and breaking strength of the left colonic anastamoses in rats. Surgery. 1994; 116:550–556.PubMedGoogle Scholar
  78. 78.
    Herndon DN, Barrow RE, Kunkel KR, et al. Effects of recombinant human growth hormone on donor-site healing in severely burned children. Ann Surg. 1990;212: 424–431.PubMedGoogle Scholar
  79. 79.
    Herndon DR, Pierre EJ, Stokes KN, et al. Growth hormone treatment for burned children. Horm Res. 1996;45(suppl 1):29–31.PubMedCrossRefGoogle Scholar
  80. 80.
    Bell R, Rosenthal RA. Surgery in the elderly. In: Hazzard WR, Blass JP, Ettinger WH, et al, eds. Principles of Geriatric Medicine and Gerontology, 4th Ed. New York: Mc Graw-Hill; 1999:391–412.Google Scholar
  81. 81.
    Rosenthal RA, Andersen DK. Surgery in the elderly: observations on the pathophysiology and treatment of cholelithiasis. Exp Gerontol. 1993;28:459–464.PubMedCrossRefGoogle Scholar
  82. 82.
    Morrow DJ, Thompson J, Wilson SE. Acute cholecystitis on the elderly. Arch Surg. 1978; 113:1149–1153.PubMedGoogle Scholar
  83. 83.
    Thornton SC. Diverticulitis and appendicitis in the elderly. In: Rosenthal RA, Zenilman ME, Katlic MR, eds. Principles and Practice of Geriatric Surgery. New York: Springer-Verlag; 2000:620–634.Google Scholar
  84. 84.
    Fried GM, Clas D, Meakins JL. Minimally invasive surgery in the elderly. Surg Clin North Am. 1994;74:375–384.PubMedGoogle Scholar
  85. 85.
    Stalnikowicz R, Eliakim R, Diab R. Crohn’s disease in the elderly. J Clin Gastroenterol. 1989; 11:411–415.PubMedCrossRefGoogle Scholar
  86. 86.
    Rosenthal RA. Small-bowel disorders and abdominal wall hernia in the elderly patient. Surg Clin North Am. 1994;74:261–291.PubMedGoogle Scholar
  87. 87.
    Hansen N, Morrow M. Breast cancer in elderly women. In: Rosenthal RA, Zenilman ME, Katlic MR, eds. Principles and Practice of Geriatric Surgery. New York: Springer-Verlag; 2000:331–342.Google Scholar
  88. 88.
    Coluccia C, Ricci EB, Marzola GG, et al. Gastric cancer in the elderly: results of surgical treatment. Int Surg. 1987;72:4–9.PubMedGoogle Scholar
  89. 89.
    Trimble EL, Carter CL, Cain D, et al. Representation of older patients in cancer treatment trials. Cancer. 1994;74:2208–2212.PubMedGoogle Scholar
  90. 90.
    The Interdisciplinary Leadership Group of the American Geriatric Society Project to Increase Geriatric Expertise in Surgical and Medical Specialties. A statement of principles: toward improving care of older patients in surgical and medical specialties. Ann Long Term Care. 2000;8:21–24.Google Scholar
  91. 91.
    Kniffin WD, Baron JA, Barrett J, et al. The epidemiology of diagnosed pulmonary embolism and deep venous thrombosis in the elderly. Arch Intern Med. 1994; 154: 861–866.PubMedCrossRefGoogle Scholar
  92. 92.
    Ibbotson SH, Tate GH, Davies JA. Thrombin activity by intrinsic activation of plasma in vitro acceleration with increasing age of the donor. Thromb Haemost. 1992;67: 377–380.PubMedGoogle Scholar
  93. 93.
    Clagett GP, Anderson FA, Geerts W, et al. Prevention of venous thromboembolism. Chest. 1998; 114(suppl):531s–560s.PubMedGoogle Scholar
  94. 94.
    Chan ED, Welsh CH. Geriatric respiratory medicine. Chest. 1998; 114:1704–1733.PubMedGoogle Scholar
  95. 95.
    Turpie AGG, Gallus AS, Hoek JA, for the pentasaccharide investigators. A synthetic pentasaccharide for the prevention of deep-vein thrombosis after total hip replacement. N Engl J Med. 2001;344:619–625.PubMedCrossRefGoogle Scholar
  96. 96.
    Mangram AJ, Horan TC, Pearson ML, et al. Guidelines for the prevention of surgical site infection, 1999. Infect Control Hosp Epidemiol. 1999;20:247–278.CrossRefGoogle Scholar
  97. 97.
    Nichols RL, Smith JW, Garcia RY, et al. Current practices of preoperative bowel preparation among North American colorectal surgeons. Clin Infect Dis. 1997;24:609–619.PubMedGoogle Scholar
  98. 98.
    Niederman M, Fein A. Community-acquired pneumonia in the elderly. In: Niederman M, ed. Respiratory Infections in the Elderly. New York: Raven Press; 1991:45–72.Google Scholar
  99. 99.
    DeVita MA, Spierer-Runback L. Swallowing disorders in patients with prolonged orotracheal intubation or tracheostomy tubes. Crit Care Med. 1990; 14:1328–1330.Google Scholar
  100. 100.
    Hogue CW, Lappas GD, Creswell LL, et al. Swallowing dysfunction after cardiac operations. J Thorac Cardiovasc Surg. 1995;110:517–522.PubMedCrossRefGoogle Scholar
  101. 101.
    Rousou JA, Tighe DA, Garb JL, et al. Risk of dysphagia after transesophageal echocardiography during cardiac operations. Ann Thorac Surg. 2000;69:486–490.PubMedCrossRefGoogle Scholar
  102. 102.
    Cheatham ML, Chapman WC, Key SP, Sawyers JL. A meta-analysis of selective versus routine nasogastric decompression after elective laparotomy. Ann Surg. 1995; 221:476–478.Google Scholar
  103. 103.
    Peters JH, Katkhouda N. Physiology of laparoscopic surgery. In: Rosenthal RA, Zenilman ME, Katlic MR, eds. Principles and Practice of Geriatric Surgery. New York: Springer-Verlag; 2000;331–342:1021–1035.Google Scholar
  104. 104.
    Rosenthal RA. Laparoscopic surgery in the elderly. In: Merrell RC, ed. Laparoscopic surgery: a colloquium. New York: Springer-Verlag; 1998:186–196.Google Scholar
  105. 105.
    Brunt LM, Soper NJ. Outcomes of minimal access vs. open surgical procedures in the elderly. In: Rosenthal RA, Zenilman ME, Katlic MR, eds. Principles and Practice of Geriatric Surgery. New York: Springer-Verlag; 2000: 1036–1053.Google Scholar
  106. 106.
    Lujan JA, Sachez-Bueno F, Parrilla P, et al. Laparoscopic vs. open cholecystectomy in patients aged 65 and older. Surg Laparosc Endosc. 1998;8:208–210.PubMedCrossRefGoogle Scholar
  107. 107.
    Jones DB, Soper NJ, Brunt M, et al. Effect of age and ASA status on the outcome of laparoscopic cholecystectomy. Surg Endosc. 1996; 10:238 [abstract].Google Scholar
  108. 108.
    Lo C, Lai E, Fan S, et al. Laparoscopic cholecystectomy for acute cholecystitis in the elderly. World J Surg. 1996;20: 983–987.PubMedCrossRefGoogle Scholar
  109. 109.
    Stocchi L, Nelson H, Young-Fadok, et al. Safety and advan-tages of laparoscopic vs. open colectomy in the elderly: matched-control study. Dis Colon Rectum. 2000;43:326–332.PubMedCrossRefGoogle Scholar
  110. 110.
    Jaklitsch MT, Bueno R, Swanson SJ, et al. New surgical options for elderly lung cancer patients. Chest. 1999; 116(suppl):480s–485s.PubMedCrossRefGoogle Scholar
  111. 111.
    Hsu TH, Fazeli-Matin S, Soble JJ, et al. Radical nephrectomy and nephrouretectomy in the octogenarian and nonagenarian. Comparison of laparosocpic and open approaches. Urology. 1999;53:1121–1125.PubMedCrossRefGoogle Scholar
  112. 112.
    Kannel WB, Dannenberg AV, Abbott RD. Unrecognized myocardial infarction and hypertension: Framingham study. Am Heart J. 1985; 109:581–585.PubMedCrossRefGoogle Scholar
  113. 113.
    Clinch D, Banerjee AK, Ostick G. Absence of abdominal pain in the elderly with peptic ulcer. Age Ageing. 1985; 13 120–123.Google Scholar
  114. 114.
    Morrison RS, Carney MT, Manfredi PL. Pain management. In: Rosenthal RA, Zenilman ME, Katlic MR, eds. Principles and Practice of Geriatric Surgery. New York: Springer-Verlag; 2000:160–173.Google Scholar
  115. 115.
    Yeager M, Glass D, Neff R, et al. Epidural anesthesia and analgesia in high risk surgical patients. Anesthesiology. 1987;66:729–736.PubMedGoogle Scholar
  116. 116.
    Egbert A, Parks L, Short L, et al. Randomized trial of postoperative patient-controlled analgesia vs. intramus-cular narcotics in frail elderly men. Arch Intern Med. 1990; 150:1897–1903.PubMedCrossRefGoogle Scholar

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  • Ronnie Ann Rosenthal

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