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MINERVA CHIRURGICA

A Journal on Surgery


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Minerva Chirurgica 2018 Apr 13

DOI: 10.23736/S0026-4733.18.07713-1

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Emergency surgery for bowel obstruction in extremely aged patients

Alberto OLDANI 1 , Valentina GENTILE 1, Chiara MAGATON 1, Marcello CALABRÒ 1, Fabio MAROSO 1, Lidia RAVIZZINI 1, Giacomo DEIRO 1, Maurizio AMATO 2, Sergio GENTILLI 1

1 Division of General Surgery, Department of Health Sciences, University of Eastern Piedmont, Hospital “Maggiore della Carità”, Novara, Italy; 2 Department of Clinical Medicine and Surgery, University “Federico II”, Naples, Italy


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BACKGROUND: As a result of the increasing of life expectancy, the incidence of pathologies that can lead to operation for bowel obstruction is also increasing. Comorbidities and reduced physiological reserve can decrease elderly patients’ ability to tolerate operations especially in an emergency context. We retrospectively evaluated the treatment and outcomes of a cohort of patients aged more than 85 years who underwent emergency surgery for intestinal occlusion.
METHODS: 278 patients who were admitted to our Institution and operated for acute bowel obstruction have been included in our study. We divided the study population in 2 groups (group A: patients aged > 85 years old; group B patients aged ≤ 85 years). We evaluated the differences between the two groups in terms of intestinal occlusion aetiology, surgical procedures, morbidity and mortality rates.
RESULTS: Group A consisted of 57 patients, group B of 221; elderly patients trend in ASA score classification was significantly towards high risk for elderly group; statistical analysis did not show differences in terms of bowel obstruction aetiology (except colon volvulus, more frequent in advanced age), type of procedure, duration of hospital stay, procedure - related complication rate. Perioperative mortality was significantly higher in elderly group, due to the mayor incidence of cardiovascular and respiratory fatal events directly related to pre - existing comorbidities.
CONCLUSIONS: Despite the high surgical risk, early diagnosis and treatment of the obstructive disease can lead to achieve encouraging outcomes also in extremely advanced age; an aggressive evaluation of comorbidies and the cardio - respiratory risks reduction, when possible, could be useful in improve postoperative outcomes in terms of mortality.


KEY WORDS: Surgery - Bowel obstruction - Geriatric

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Publication History

Article first published online: April 13, 2018
Manuscript accepted: April 10, 2018
Manuscript received: March 15, 2018

Cite this article as

Oldani A, Gentile V, Magaton C, Calabrò M, Maroso F, Ravizzini L, et al. Emergency surgery for bowel obstruction in extremely aged patients. Minerva Chir 2018 Apr 13. DOI: 10.23736/S0026-4733.18.07713-1

Corresponding author e-mail

alberto.oldani@libero.it