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Surgery Today 2019-Oct

Super-elderly patient-specific perioperative complications in breast cancer surgery.

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Yoshinari Ogawa
Katsumi Ikeda
Chika Watanabe
Yuri Kamei
Wataru Goto
Chika Shiraishi
Shinya Tokunaga
Yuko Tsuboguchi

Mots clés

Abstrait

Geriatric surgery poses specific challenges due to patient vulnerability in relation to aging. We analyzed perioperative challenges concerning super-elderly patients with breast cancer.Between 2013 and 2018, 908 patients with breast cancer were treated surgically. Of these, two patient groups were compared: Group A (≥ 85 years old, n = 34, 3.7%) and Group B (75-84 years old, n = 136, 15%).In Groups A and B, 26.4% and 36.8% of patients lived alone, respectively. Group A patients had higher rates of psychiatric and cardiovascular disease (32.4% and 41.2%) than Group B (8.8% and 16.2%) (p = 0.0009 and p = 0.0031, respectively). There was no marked difference in the type of surgery or length of hospital stay between groups, and most complications involved surgical site disorders. Postoperatively, Group A had a higher rate of delirium (29.4%) than Group B (3.7%) (p < 0.0001). The 30-day postoperative mortality rate was 0, and 76.5% of Group A and 45.6% of Group B patients received no adjuvant therapy (p = 0.0024).Age alone does not constitute a contraindication for appropriate surgery, although there are some challenges necessary to consider for super-elderly patients.

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