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Emergency Surgery in the Elderly: Could Laparoscopy Be Useful in Frailty? A Single-Center Prospective 2-Year Follow-Up in 120 Consecutive Patients

1
Department of General Surgery, ULSS5 Polesana del Veneto, Santa Maria della Misericordia Hospital, 45011 Adria, Italy
2
Department of General Surgery, Ospedale Civile Santi Giovanni and Paolo, 30122 Venezia, Italy
3
Department of Engineering, University of Ferrara, 44121 Ferrara, Italy
4
Cambridge University Hospitals, Cambridge CB2 0QQ, UK
5
Department of Surgery, University of Insubria, 21100 Varese, Italy
*
Author to whom correspondence should be addressed.
Academic Editor: Cornelis F.M. Sier
Received: 5 January 2021 / Revised: 7 March 2021 / Accepted: 10 March 2021 / Published: 14 March 2021
Background: the general population is aging across the world. Therefore, even surgical interventions in the elderly—in particular those involving emergency surgical admissions—are becoming more frequent. The elderly population is often frail (in multiple physiological systems, this is often defined as age-related cumulative decline). This study involved a 2-year follow-up evaluation of frail elderly patients treated with urgent surgical intervention at Santa Maria Regina della Misericordia Hospital, General Surgery Department, in Adria (Italy). Method: a prospective, single-center, 2-year follow-up study of 120 patients >65 years old, treated at our department for surgical abdominal emergencies. We considered co-morbidities (ASA—American Society of Anesthesiologists Physical Status Classification System—score), type of surgery (laparoscopy, laparotomy or converted), frailty score, mortality, and complications at 30 days and at 2 years. Conclusions: 70 (58.4%) patients had laparoscopy, 49 (40.8) had laparotomy, and in 1 (0.8%) case, surgery was converted from laparoscopy to laparotomy. Mortality strictly depends on the type of surgery (laparotomy vs. laparoscopy), complications during recovery, and a lower Fried frailty criteria score, on average. The long-term follow-up can be a useful tool to highlight a safer surgical approach, such as laparoscopy, in frail elderly patients. We consider the laparoscopic approach feasible in emergency situations, with similar or better outcomes than laparotomy, especially in frail elderly patients. View Full-Text
Keywords: laparoscopy; urgent surgery; elderly; frailty laparoscopy; urgent surgery; elderly; frailty
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MDPI and ACS Style

Zese, M.; Finotti, E.; Cestaro, G.; Cavallo, F.; Prando, D.; Gobbi, T.; Zese, R.; Di Saverio, S.; Agresta, F. Emergency Surgery in the Elderly: Could Laparoscopy Be Useful in Frailty? A Single-Center Prospective 2-Year Follow-Up in 120 Consecutive Patients. Surgeries 2021, 2, 119-127. https://0-doi-org.brum.beds.ac.uk/10.3390/surgeries2010011

AMA Style

Zese M, Finotti E, Cestaro G, Cavallo F, Prando D, Gobbi T, Zese R, Di Saverio S, Agresta F. Emergency Surgery in the Elderly: Could Laparoscopy Be Useful in Frailty? A Single-Center Prospective 2-Year Follow-Up in 120 Consecutive Patients. Surgeries. 2021; 2(1):119-127. https://0-doi-org.brum.beds.ac.uk/10.3390/surgeries2010011

Chicago/Turabian Style

Zese, Monica, Elena Finotti, Giovanni Cestaro, Fabio Cavallo, Daniela Prando, Tobia Gobbi, Riccardo Zese, Salomone Di Saverio, and Ferdinando Agresta. 2021. "Emergency Surgery in the Elderly: Could Laparoscopy Be Useful in Frailty? A Single-Center Prospective 2-Year Follow-Up in 120 Consecutive Patients" Surgeries 2, no. 1: 119-127. https://0-doi-org.brum.beds.ac.uk/10.3390/surgeries2010011

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