Avaliação perioperatória através do holter em pacientes idosos submetidos à prostatectomia

Cançado, Thais Orrico de Brito; Leitão, Fernando Bueno Pereira; Torres, Marcelo Luís Abramides; Brito, Fábio Sândoli de

doi:10.1590/s0066-782x2009001000015

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“…On the other hand, in elderly patients with no history of heart disease undergoing TURP, continuous ECG Holter monitoring during the pre- intra- and post-operative periods was not able to detect significant variations in electrocardiographical signs indicative for ischemic disease [43]. …”

Section: Discussionmentioning

confidence: 99%

Risk of acute myocardial infarction after transurethral resection of prostate in elderly

et al. 2013

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BackgroundBenign prostatic hyperplasia is a frequent disease among elderly, and is responsible for considerable disability. Benign prostatic hyperplasia can be clinically significant due to lower urinary tract symptoms that take place because the gland is enlarged and obstructs urine flow. Transurethral resection of the prostate remains the gold standard treatment for patients with moderate or severe symptoms who need active treatment or who either fail or do not want medical therapy. Moreover, perioperative and postoperative surgery complications as cardiovascular ones still occur. The incidence of acute myocardial infarction in patients undergoing transurethral resection of the prostate is controversial. The first studies showed an increase in mortality and relative risk of death from myocardial infarction in transurethral resection of the prostate group vs open prostatectomy but these results are in contrast with more recent data.DiscussionGiven the conflicting evidence of the studies in the literature, in this review we are going to discuss the factors that may influence the risk of myocardial infarction in elderly patients undergoing prostate surgery. We analyzed the possible common factors that lead to the development of myocardial infarction and benign prostatic hyperplasia (cardiovascular and metabolic), the stressor factors related to prostatectomy (surgical and haemodynamic) and the risk factors specific of the elderly population (comorbidity and therapies).SummaryAlthough transurethral resection of the prostate is considered at low risk for severe complications, there are several reports indicating that cardiovascular events in elderly patients undergoing this surgical operation are more common than in the general population. Several cardio-metabolic, surgical and aging-related factors may help explain this observation but results in literature are not concord, especially due to the fact that most data derive from retrospective studies in which selection bias cannot be excluded. Subsequently, further studies are necessary to clarify the incidence of acute myocardial infarction in old people.

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Section: Discussionmentioning

confidence: 99%