Recent Approaches in Geriatric Surgery

Abstract

Physiological aging creates several risks for biological losses and atypical processes. Surgical interventions may be required to manage these risks. The goals in geriatric surgery are to extend the person's healthy life span, survival time, and quality of life as much as possible. In addition to routine prohibitions, age-modified measures and arrangements should be planned preoperative and postoperative processes of the geriatric surgery in the light of current approaches and scientific guidelines.

Keywords

• geriatric surgery
• Geriatrics
• elderly

Geriatrik Cerrahide Güncel Yaklaşımlar

Abstract

Fizyolojik yaşlanmanın biyolojik kayıplar ve atipik hastalık süreçleri adına yarattığı kimi riskler mevcuttur. Bu risklerin yönetilebilmesi adına cerrahi müdahaleler gerekebilmektedir. Geriatrik cerrahide hedefler kişinin sağlıklı ömür uzunluğunu, hayatta kalma süresini ve yaşam kalitesini olabildiğince uzatmaktır. Geriatrik cerrahi öncesinde, sırasında ve sonrasında diğer yaş gruplarında alınan önlemlere ek olarak planlanması gereken tedbirler ve düzenlemelerin güncel yaklaşımlar ve bilimsel kılavuzlar ışığında incelenmesi gerekmektedir.

Keywords

• Geriatri
• geriatrik cerrahi
• yaşlı

References

1. Türkiye İstatistik Kurumu. Nüfus Projeksiyonları, 2018-2080. TÜİK. http://www.tuik.gov.tr/PreHaberBultenleri.do?id=30567. Yayınlanma tarihi Şubat 2018. Erişim tarihi 04 Haziran 2020.
2. Tufan İ. Türkiye’de Sosyal ve Uygulamalı Gerontolojinin Tarihsel Temelleri. In: Durak M ve Tufan İ. Gerontoloji 1. İstanbul: Nobel;2017.
3. Office for National Statistics. Estimates of the very old (including Centenarians): England and Wales, and United Kingdom, 2002 to 2014. Office for National Statistics. http://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/ageing/bulletins/estimatesoftheveryoldincludingcentenarians/2015-09-30. Yayınlanma tarihi Eylül 2015. Erişim tarihi 04 Haziran 2020.
4. Etzioni DA, Liu JH, Maggard MA, et al. The aging population and its impact on the surgery workforce. Ann Surg. 2003;238:170–177.
5. Pearce L, Bunni J, McCarthy K, Hewitt J. Surgery in the older person: training needs for the provision of multidisciplinary care. Ann R Coll Surg Engl. 2016;98(6):367‐370. doi:10.1308/rcsann.2016.0180.
6. Reiss R. Moral and ethical issues in geriatric surgery. J Med Ethics. 1980;6(2):71‐77. doi:10.1136/jme.6.2.71.
7. Katlic MR. Principles of Geriatric Surgery. In: Rosenthal RA, Zenilman ME, Katlic MR. Principles and Practice of Geriatric Surgery. 2nd ed. New York: Springer; 2011.
8. Aydın K, Arıoğul S. Geriatrik Populasyonda Perioperatif Değerlendirme. In: Sarıoğul S. Geriatri ve Gerontoloji. Ankara: MN Medikal ve Nobel Ltd. Şti; 2006.

9. Prins MH, Hirsh J. A comparison of general anesthesia and regional anesthesia as a risk factor for deep vein thrombosis following hip surgery: a critical review. Thromb Haemost. 1990;64(4):497‐500.
10. Wijeysundera DN, Naik JS, Beattie WS. Alpha-2 adrenergic agonists to prevent perioperative cardiovascular complications: a meta-analysis. Am J Med. 2003;114(9):742-752. doi:10.1016/s0002-9343(03)00165-7
11. Wilson SH, Fasseas P, Orford JL, et al. Clinical outcome of patients undergoing non-cardiac surgery in the two months following coronary stenting. J Am Coll Cardiol. 2003;42(2):234‐240. doi:10.1016/s0735-1097(03)00622-3
12. Corish CA. Pre-operative nutritional assessment in the elderly. J. Nutr. Health Aging. 2001;5:49–59.
13. Eikelboom JW, Quinlan DJ, Douketis JD. Extended-duration prophylaxis against venous thromboembolism after total hip or knee replacement: a meta-analysis of the randomised trials. Lancet. 2001;358(9275):9‐15. doi:10.1016/S0140-6736(00)05249-1
14. Turpie AG, Bauer KA, Eriksson BI, Lassen MR. Fondaparinux vs enoxaparin for the prevention of venous thromboembolism in major orthopedic surgery: a meta-analysis of 4 randomized double-blind studies. Arch Intern Med. 2002;162(16):1833‐1840. doi:10.1001/archinte.162.16.1833
15. Sandham JD, Hull RD, Brant RF, et al. A randomized, controlled trial of the use of pulmonary-artery catheters in high-risk surgical patients. N Engl J Med. 2003;348(1):5‐14. doi:10.1056/NEJMoa021108
16. Khadka R, Tian W, Hao X, Koirala R. Risk factor, early diagnosis and overall survival on outcome of association between pancreatic cancer and diabetes mellitus: changes and advances, a review. Int J Surg. 2018;52:342‐346. doi:10.1016/j.ijsu.2018.02.058
17. Harari D, Hopper A, Dhesi J, et al. Proactive care of older people undergoing surgery (’POPS’): designing, embedding, evaluating and funding a comprehensive geriatric assessment service for older elective surgical patients. Age Ageing. 2007;36:190–196.
18. Marti GP, Liu L, Zhang X, et al. Wound Healing in the Elderly. In: Rosenthal RA, Zenilman ME, Katlic MR. Principles and Practice of Geriatric Surgery. 2nd ed. New York: Springer; 2011.
19. Committee on Approaching Death: Addressing Key End of Life Issues; Institute of Medicine. Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life. Washington (DC): National Academies Press (US); 2015.
20. Casarett D, Johnson M, Smith D, et al. The optimal delivery of palliative care: a national comparison of the outcomes of consultation teams vs inpatient units. Arch Intern Med. 2011;171(7):649–55.
21. Temel JS, Greer JA, Muzikansky A, et al. Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med. 2010;363(8):733–42.
22. Yoo JW, Nakagawa S, Kim S. Integrative palliative care, advance directives, and hospital outcomes of critically ill older adults. Am J Hosp Palliat Care. 2012;29(8):655–662.
23. May P, Garrido MM, Cassel JB, et al. Cost analysis of a prospective multi-site cohort study of palliative care consultation teams for adults with advanced cancer: where do cost-savings come from? Palliat Med. 2017;31(4):378–386.
24. Ciemins EL, Blum L, Nunley M, et al. The economic and clinical impact of an inpatient palliative care consultation service: a multifaceted approach. J Palliat Med. 2007;10(6):1347–1355.
25. May P, Normand C, Morrison RS. Economic impact of hospital inpatient palliative care consultation: review of current evidence and directions for future research. J Palliat Med. 2014;17(9):1054–1063.
26. Ballou JH, Brasel KJ. Palliative care and geriatric surgery. Clin Geriatr Med. 2019;35(1):35‐44. doi:10.1016/j.cger.2018.08.004
27. American Society of Anesthesiologists. ASA Physical Status Classification System. ASA. https://www.asahq.org/standards-and-guidelines/asa-physical-status-classification-system. Yayınlanma tarihi Ekim 2019. Erişim tarihi 04 Haziran 2020.
28. Al-Temimi MH, Griffee M, Enniss TM, et al. When is death inevitable after emergency laparotomy? Analysis of the American College of Surgeons National Surgical Quality Improvement Program database. J Am Coll Surg. 2012;215(4):503–11.
29. Lewis MC, Yeldo NS. The ethics of surgery at end of life. Anesthesiol Clin. 2019;37(3):561‐571. doi:10.1016/j.anclin.2019.04.005
30. Nabozny MJ, Kruser JM, Steffens NM, et al. Constructing high-stakes surgical decisions: it’s better to die trying. Ann Surg. 2016;263(1):64–70.
31. Zenilman ME. Ethical Considerations. In: Rosenthal RA, Zenilman ME, Katlic MR. Principles and Practice of Geriatric Surgery. New York: Springer; 2000.
32. Jahnigen DW. Interacting with the Elderly Patient, Family, and Referring Physicians. In: Rosenthal RA, Zenilman ME, Katlic MR. Principles and Practice of Geriatric Surgery. New York: Springer; 2000: Chapter 9.
33. Tufan İ. Gerontoloji Meslek Yemini. In: Gerontoloji Ödülleri Açılış Konuşması; 2016; Dinar, Türkiye.