Urologic Laparoscopic Surgeries in Elderly: Analysis of Pre-Operative Risk Factors and Postoperative Complications

Abstract

Purpose: The aging of the population leads to increases in the prevalence of symptomatic urologic diseases. The aim of this study is the analysis of pre-operative risk factors and postoperative complications in patients over the age of 60 years undergoing elective laparoscopic urologic surgery. Patients and Methods: A retrospective study was conducted of 113 patients 60 years of age or older who underwent urologic laparoscopic surgery by a single surgeon (SP). The preoperative physical status and systemic complications, operation time, postoperative complications, postoperative hospital stay and other clinical features of the patients were reviewed. Complications were classified according to the recently revised Clavien classification system. Statistical analysis was done using Univariate analysis and the Fisher Exact test. Results: Laparoscopic urologic surgery was performed on 113 patients 60 years old and over, with an average age of 69.6 years. Associated diseases were found in 92% of them. Pelvic surgery (65 ; 57.5%) was the main reason for surgery. There were 5 (4.4%) conversions to open surgery and 0% mortality. The overall complication rate was 10 patients (8.8%). Among 9 (7.96%) patients with post-operative complications; Grade I, II, IIIa, IIIb and IV complications were observed in 1.77%, 12.8%, 3.53%, 0.88% and 0.88% of cases, respectively. Sex with male, operative time ≥ 250 min and cancer had high risk ratio (2.76, 2.11 and 3.02, respectively); however the correlations of all of preoperative risk factors and postoperative complications showed no statistically significant differences. Conclusions: Laparoscopic surgical treatment of urologic disease in elderly patients performed is feasible and well tolerated, with low perioperative morbidity and a good overall survival rate. Pre-operative risk factors may not influence postoperative complications in patients over the age of 60 years undergoing elective laparoscopic urologic surgery.