Surgery in Centenarians

Katlic, Mark R.

doi:10.1001/jama.1985.03350450111033

Cited by 46 publications

(2 citation statements)

References 24 publications

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“…This is the case even for Danish centenarians of whom about two thirds take cardiovascular drugs, including antiplatelets, anticoagulants and beta-blockers (30,63). Furthermore, a number of clinical studies indicate that mortality after major operations of old people with, e.g., hip fractures and cancer has declined, and age limits for surgery on elderly people have been replaced by clinical criteria to a degree that today even centenari-ans are operated with success (69)(70)(71)(72)(73). A similar change is true of medical treatment for other potentially fatal diseases.…”

Section: Possible Period Effectsmentioning

confidence: 99%

Living longer — but better?

Jeune

2002

Aging Clin Exp Res

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The highest attained age has increased by about 20 years since the beginning of the 19th century. In the course of the 1990s, more than ten individuals reached 115 years or more, including Jeanne Calment who attained the age of 122 years. In low-mortality countries, the number of centenarians has doubled every decade since 1950. This dramatic increase was mainly due to periodical effects related to the drastic fall in mortality among the elderly. The fact that centenarians are survivors does not mean that they are healthy. A high prevalence of comorbidity is found, and many centenarians have survived major diseases thanks to medical treatment and surgery. It is, however, possible that the comorbidity is less serious than in younger elderly. Certain personality traits may also be important in surviving health-threatening conditions. Furthermore, a number of biological and cognitive functions seem to be well-preserved in several centenarians. The influence of the apoE-gene and other genes involved in fundamental mechanisms illustrates that with advancing age and increasing mortality even small risks may have a substantial effect on survival to 100 years. A small proportion of long-livers may be considered as relatively autonomous, and this proportion will probably increase in the future. We are living longer and seem to postpone the terminal dependent phase to higher ages. Longevity may thus be perceived as part of our postmodern condition with its mix of pleasure and suffering.

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Section: Possible Period Effectsmentioning

confidence: 99%

Living longer — but better?

Jeune

2002

Aging Clin Exp Res

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“…There are few published articles regarding surgery in centenarians. Available studies 2,3 seem to suggest no significant increase in mortality. A coordinate care approach between surgical and geriatric medical teams is highly desirable to ensure a good outcome 4 .…”

Section: Surgery In the Very Elderlymentioning

confidence: 99%

Surgery in the very elderly

Ozorio

Chan

2007

Internal Medicine Journal

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A 102-year-old woman was previously well, independent in her daily activities and lived with her son. She presented to our hospital with a 3-day history of non-specific abdominal and bilateral upper leg pain, absolute constipation and one episode of dark vomitus. On examination, she was 55 kg, slightly dehydrated, afebrile, blood pressure 130/85 mmHg, pulse rate 80/min, respiratory rate 18/min and S A O 2 99% with room air. Her abdomen was mildly distended and tender on deep palpation centrally. There was no other significant finding on examination. She was reviewed by a geriatrician the next morning and was found to have both hips in flexion position with no visible femoral or inguinal hernia.Plain abdominal radiograph showed dilated loops of small bowel with multiple fluid levels on decubitus views. Chest radiograph showed no gas under the diaphragm. Her urea was slightly raised at 15 mm/L, white cell count was mildly increased at 12.2 Â 10 6 /L, whereas electrolytes, amylase, lipase, haemoglobin and platelets were normal.Obturator hernia was suspected and was confirmed by abdominal computed tomography (CT) scan, which showed a solitary bowel loop in the left obturator canal posterior to the pectineus muscle. Emergency laparotomy was carried out, which showed complete distal small bowel obstruction secondary to the hernia. A 10-cm segment of infracted small bowel was resected. The hernia was reduced and small bowel anastomosis was carried out; peritoneum over the obturator space was opened with polypropylene mesh repair.

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Nasal Reconstruction in the Elderly Patient

Shumrick

Campbell²,

Becker³

1999

Archives of Facial Plastic Surgery

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To review a series of nasal reconstructive procedures in elderly patients, and to discuss management issues related to reconstructing nasal defects in patients 80 years and older.Design: Retrospective review identifying patients 80 years and older undergoing significant nasal reconstructive surgery.Setting: University and private practice settings.Patients: Patients 80 years and older requiring significant nasal reconstructive surgery, with nasal defect large enough to require a forehead flap for skin resurfacing. Patients whose defects were allowed to granulate or who had skin grafts were excluded.Intervention: Nasal reconstructive surgery using advanced surgical techniques such as forehead flaps and cartilage grafts.Main Outcome Measures: Complications related to surgery or use of anesthesia and whether patients believed the effort and resources required to complete the nasal reconstruction were worth it.Results: Fifteen patients 80 years and older underwent nasal reconstructive surgery using forehead flaps. In addition, 5 patients had intranasal mucosal grafts and 6 had cartilage grafts. There were no instances of anesthetic or perioperative morbidity or mortality. In addition, all flaps completely survived, and results were judged as good to excellent.Conclusions: Actuarial evidence shows that a 90-yearold American woman has a 40% chance of living to be 95 years old. Presently, with the improved level of functioning of octogenarians and nonagenarians, we are also concerned with their facial appearance, and want to use the optimum reconstructive technique. The decision of what type of reconstructive surgery to perform should not be based simply on a patient's age but must also take into account the patient's mental status and wishes, and medical condition. Our evidence supports the concept that, in the appropriately chosen patient 80 years and older, forehead flaps and cartilage grafting can be performed without significant morbidity.

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Surgery in Centenarians

Cited by 46 publications

References 24 publications

Living longer — but better?

Living longer — but better?

Surgery in the very elderly

Nasal Reconstruction in the Elderly Patient

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