Optimizing the results of surgical treatment in geriatric patients with colorectal carcinoma
DOI:
https://doi.org/10.5281/zenodo.17954576Keywords:
geriatric surgery, colorectal surgeryAbstract
INTRODUCTION: In recent decades, there has been a growing trend toward increased life expectancy. At the same time, the number of patients with colorectal carcinoma is increasing, which leads to a greater number of patients who need surgical treatment. Age is a significant risk factor for the development of CRC, but advanced age itself is an important risk factor for postoperative morbidity and mortality.
OBJECTIVE: To analyze patients aged 75 years and older who underwent surgery for colorectal carcinoma at the Surgery Clinic of the hospital "Saint Anna" Sofia, comparing outcomes between patients who underwent elective surgery and those who underwent emergency surgery.
MATERIALS AND METHODS: We conducted a retrospective, non-randomized study of geriatric patients who underwent surgery for a 3-year period (2022-2024). We analyzed the demographic data, nosological units, comorbidities, polypharmacy, surgical techniques, length of hospital stay, postoperative complications, and mortality.
RESULTS: A total of 132 patients were operated on for colorectal carcinoma during the period: 68 men and 64 women. Elective surgery was performed in 98 patients, and 34 underwent emergency surgery. Nearly 50% were in their ninth decade of life. The relative share of comorbidity was high, above 90%. Hospital stay ranged from 1 to 31 days and was significantly longer for emergency surgeries. Mortality for elective surgery was 10.2%, while in emergency cases it reached 50%.
DISCUSSION AND CONCLUSION: The findings of our research underline the importance of optimizing the surgical treatment for geriatric patients with colorectal carcinoma. Key factors in this optimization process include accurate and timely detection of treatable pathology, a comprehensive geriatric assessment, and necessary preoperative preparation to improve physiological status, comorbidities, and specific geriatric syndromes. The appropriate choice of anesthesiological and surgical techniques, combined with adequate postoperative care and rehabilitation, further contributes to the success of the treatment. Elective surgery significantly reduces the risks of complications, morbidity, and mortality that are characteristic of emergency interventions.
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