Laparoscopic GI Surgery Safe for Octogenarians

Major complications occurred in 21 patients (36%) over the 30-day postoperative period. They included two cardiac arrhythmias; four cases of dysphagia, three of which required dilation; one empyema and one aspiration pneumonia that required admission to the intensive care unit; and four cases of anemia that required transfusion.

Two patients died in the hospital after surgery. One patient had an esophageal leak that was repaired, but resulted in a fatal sepsis. One patient needed a reoperation for bleeding and subsequently developed renal and cardiac failure; the family elected to withdraw life support.

Dr. Fitzgerald had complete 1-month follow-up data on 86% of the patients (51). Thirty-nine percent of the patients (23) reported complete symptom resolution, and 47% (28) reported partial resolution.

“This was a small sample size, but despite this, we feel that laparoscopic paraesophageal hernia repair can be performed safely with minimal perioperative morbidity in octogenarians. We now advocate this approach as opposed to watchful waiting in this subset of symptomatic patients.”