Invited Commentary

  • Courtney M. TownsendJr.


A 92-year-old widow, who lived alone, underwent a ­laparoscopic right hemicolectomy for a stage IIA cecal cancer found on workup after falling while climbing stairs at her home. Past history is important because of lack of systemic disease, no prescription medications, and only one visit to a doctor (for dog bite at an age of 86) in the past 57 years. She had no nasogastric tube and was disoriented periodically for the first two postoperative days with complete clearing without treatment and transferred to a rehabilitation floor on the seventh day for 2 weeks of reconditioning. She returned home where she resumed her activity, but with caregivers living with her. She had one postoperative visit with her ­doctor, then no further follow-up. At an age of 98, after 2 days of failure to eat and two episodes of vomiting, she was found to have a circumferential lesion in the mid-sigmoid colon that prevented retrograde passage of barium administered by enema. She had an emergency Hartmann’s resection for a stage IIIB sigmoid colon cancer. Both the surgeon and anesthesiologist remarked that they had never taken part in an operation on a 98-year-old patient. The patient had no nasogastric tube, was disoriented periodically for the first three postoperative days, which cleared without treatment, and she was discharged to a rehabilitation floor for 3 weeks. The patient required no narcotics after either operation. She then returned to her home where she resumed her activity and died 1 month short of her 101st birthday.


Elderly Patient Systemic Disease Comorbid Condition Past History Prescription Medication 
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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Department of SurgeryUniversity of Texas Medical BranchGalvestonUSA

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