Advantages of laparoscopy in gynecologic surgery in elderly patients

OBJECTIVE: Geriatric patients requiring gynecological surgery is increasing worldwide. However, older patients are at higher risk of postoperative morbidity and mortality, particularly cardiopulmonary complications. Laparoscopic surgery is widely used as a minimally invasive method for reducing postoperative morbidities. We compared the outcomes of open and laparoscopic gynecologic surgeries in patients older than 55 years.

METHODS: We included patients aged >55 years who underwent gynecological surgery at a single tertiary center between 2010 and 2020, excluding vaginal or ovarian cancer surgeries were excluded. Surgical outcomes were compared between the open surgery and laparoscopic groups, with age cutoff was set at 65 years for optimal discriminative power. We performed linear or logistic regression analyses to compare the surgical outcomes according to age and operation type.

RESULTS: Among 2,983 patients, 28.6% underwent open surgery and 71.4% underwent laparoscopic surgery. Perioperative outcomes of laparoscopic surgery were better than those of open surgery in all groups. In both the open and laparoscopic surgery groups, the older patients showed worse overall surgical outcomes. However, age-related differences in perioperative outcomes were less severe in the laparoscopic group. In the linear regression analysis, the differences in estimated blood loss, transfusion, and hospital stay between the age groups were smaller in the laparoscopy group. Similar restuls were observed in cancer-only and benign-only cohorts.

CONCLUSION: Although the surgical outcomes were worse in the older patients, the difference between age groups was smaller for laparoscopic surgery. Laparoscopic surgery offers more advantages and safety in patients aged >65 years.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:67

Enthalten in:

Obstetrics & gynecology science - 67(2024), 2 vom: 28. März, Seite 243-252

Sprache:

Englisch

Beteiligte Personen:

Na, Jaewon [VerfasserIn]
Chung, Young Eun [VerfasserIn]
Jang, Il-Yeo [VerfasserIn]
Lee, Yoo-Young [VerfasserIn]
Kim, Tae-Joong [VerfasserIn]
Lee, Jeong-Won [VerfasserIn]
Kim, Byoung-Gie [VerfasserIn]
Chang, Chi-Son [VerfasserIn]
Choi, Chel Hun [VerfasserIn]

Links:

Volltext

Themen:

Aged
Geriatric
Gynecological surgery
Journal Article
Minimally invasive surgical procedure

Anmerkungen:

Date Revised 20.03.2024

published: Print-Electronic

Citation Status PubMed-not-MEDLINE

doi:

10.5468/ogs.23238

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM365439339