scholarly journals Colorectal Cancer in Elderly Patients with Surgical Indication: State of the Art, Current Management, Role of Frailty and Benefits of a Geriatric Liaison

2021 ◽  
Vol 18 (11) ◽  
pp. 6072
Author(s):  
Nicolás M. González-Senac ◽  
Jennifer Mayordomo-Cava ◽  
Angela Macías-Valle ◽  
Paula Aldama-Marín ◽  
Sara González ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Elderly Patients ◽  
Preoperative Evaluation ◽  
The Elderly ◽  
Surgical Indication ◽  
Surgical Approaches ◽  
Operative Complications ◽  
Geriatric Intervention ◽  
Operative Recovery ◽  
Post Operative Complications

Six out of every 10 new colorectal cancer (CRC) diagnoses are in people over 65 years of age. Current standardized surgical approaches have proved to be tolerable on the elderly population, although post-operative complications are more frequent than in the younger CRC population. Frailty is common in elderly CRC patients with surgical indication, and it appears to be also associated with an increase of post-operative complications. Fast-track pathways have been developed to assure and adequate post-operative recovery, but comprehensive geriatric assessments (CGA) are still rare among the preoperative evaluation of elderly CRC patients. This review provides a thorough study of the effects that a CGA assessment and a geriatric intervention have in the prognosis of CRC elderly patients with surgical indication.

scholarly journals Characteristics of Moyamoya Disease in the Older Population: Is It Possible to Define a Typical Presentation and Optimal Therapeutical Management?

2021 ◽  
Vol 10 (11) ◽  
pp. 2287
Author(s):  
Ignazio G. Vetrano ◽  
Anna Bersano ◽  
Isabella Canavero ◽  
Francesco Restelli ◽  
Gabriella Raccuia ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Perioperative Complications ◽  
Artery Bypass ◽  
Superficial Temporal Artery ◽  
Brain Perfusion ◽  
Temporal Artery ◽  
Minimal Invasive ◽  
Operative Complications ◽  
Surgical Options ◽  
Post Operative Complications

Whereas several studies have been so far presented about the surgical outcomes in terms of mortality and perioperative complications for elderly patients submitted to neurosurgical treatments, the management of elderly moyamoya patients is unclear. This review aims to explore the available data about the clinical manifestation, characteristics, and outcome after surgery of older patients with moyamoya arteriopathy (MA). We found only two articles strictly concerning elderly patients with MA. We have also evaluated other reported adult series of moyamoya patients, including elderly cases in their analysis. Patients with MA above 50 years old may be considered a peculiar subset in which patients are often presenting with ischemic symptoms and a higher Suzuki grade. Conservative treatment may be proposed in asymptomatic or stable cases due to their fragility and possible increase of post-operative complications, while the best surgical options in symptomatic cases are still under investigation, although we believe that a minimal invasive superficial temporal artery—middle cerebral artery bypass could be considered the treatment of choice for the immediate effect on brain perfusion with a limited rate of post-operative complications.

Prevalence of geriatric syndromes and study of early post-surgical functionality in elderly patients with colorectal cancer and surgical indication

2021 ◽  
Vol 12 (8) ◽  
pp. S54-S55
Author(s):  
N.M. Gonzalez-Senac ◽  
M.L. Cruz-Arnes ◽  
C. Paniagua Carrasco ◽  
J. Mayordomo-Cava ◽  
M.T. Vidan ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Elderly Patients ◽  
Surgical Indication ◽  
Geriatric Syndromes

Surgical Approaches to the Irradiated Breast

2020 ◽  
Author(s):  
Megan Fracol ◽  
Neil Fine
Keyword(s):  
Radiation Therapy ◽  
Breast Surgery ◽  
Surgical Approaches ◽  
Autologous Reconstruction ◽  
Breast Irradiation ◽  
Surgery Complications ◽  
Number Of Patients ◽  
Operative Complications ◽  
Salvage Mastectomy ◽  
Post Operative Complications

The use of radiation therapy for treatment of breast cancer has steadily increased since the 1990s. Plastic surgeons must be prepared to reconstruct patients with prior lumpectomy and radiation now needing salvage mastectomy, as well as the growing number of patients who will go on to need post mastectomy radiation therapy. Operating in the irradiated field presents unique challenges, including but not limited to intra-operative difficulties such as friable vessels when performing autologous-based reconstruction and higher rates of post-operative complications when performing implant-based reconstruction. Reconstructed outcomes are often inferior to the non-irradiated patient and as such the plastic surgeon should be prepared to perform further revision as necessary. This chapter will review indications for radiation therapy, both autologous- and implant-based approaches to reconstructing the irradiated breast and how to manage post-operative complications. This review contains 3 figures, 5 tables, and 75 references. Keywords: radiation, breast irradiation, breast reconstruction, radiation therapy, autologous reconstruction, implant-based reconstruction, revisionary breast surgery, complications

Abdominal sacrohysteropexy UV prolapse and preservation of reproduction.

2021 ◽  
Vol 28 (05) ◽  
pp. 652-655
Author(s):  
Robina Ali ◽  
Riffat Ehsan ◽  
Ghazala Niaz ◽  
Fatima Abid
Keyword(s):  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Uterovaginal Prolapse ◽  
Prolapse Recurrence ◽  
Gynecology And Obstetrics ◽  
Duration Of Surgery ◽  
Operative Complications ◽  
Operative Recovery ◽  
Post Operative Complications

Objectives: The purpose of this study was to assess the safety of sacrohystcopxy by determining intraoperative and post-operative complications and its effectiveness by pelvic organ prolapse recurrence on follow up. Study Design: Prospective study. Setting: Department of Gynecology and Obstetrics Unit-II DHQ Hospital PMC, Faisalabad. Period: Jan-2014 to Jan-2017. Material & Methods: Patients with uterovaginal prolapse, admitted through OPD were selected for abdominal sacrohysteropexy. Variables of study including duration of surgery, any intra-operative and post operative complications, need of intra operative blood transfusion, post operative hospital stay; recurrence of POP, number of pregnancies in 06 moths follow up were recorded. Results: During this study period, 319 patients were admitted with uterovaginal prolapse. 32 (10.03%) cases were selected for abdominal sacrohysteropexy. In these 32 patients, 03 (9.37%) were <30years of age, 21(65.62%) were between 30-35 years and 8 (25%) were between 35-40 years of age. About 2(6.25%) were unmarried, while 30(93.7%) were married. In these married women 14(43.75%) were multiparas, another 14(43.75%) were para 1 or 2, while 4(12.5%) were para 3 or more. Duration of surgery was 40-45 minutes in 31(96.87%) patients. In 28(87.5%) cases per operative blood loss was <150ml while in 4(12.5%) it was estimated to be >150ml but less than 300ml. Post operatively only 1(3.12%) case developed wound sepsis and it was the only one (3.12%) who was discharged on 7th post operative day, while rest 31(96.87%) were discharged on 3rd post operative day. No recurrence was noticed in 06 moths follow up, while 2(6.25%) patients became pregnant. Conclusion: Abdominal sacrohysteropexy is a safe and an effective treatment in terms of overall anatomical and functional outcome, complications, post operative recovery, length of hospital stay and sexual functioning, in women who desire uterine and hence fertility preservation.

scholarly journals The effect of geriatric intervention in frail elderly patients receiving chemotherapy for colorectal cancer: a randomized trial (GERICO)

BMC Cancer ◽  
2017 ◽  
Vol 17 (1) ◽  
Author(s):  
C. M. Lund ◽  
K. K. Vistisen ◽  
C. Dehlendorff ◽  
F. Rønholt ◽  
J. S. Johansen ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Elderly Patients ◽  
Randomized Trial ◽  
Frail Elderly ◽  
Geriatric Intervention

Clinical and pathological characteristics of elderly colorectal cancer patients over 70 years old and comparison with patients under 50 years old.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e14174-e14174
Author(s):  
Betul Erismis ◽  
Nadire Kucukoztas ◽  
Samed Rahatli ◽  
Selim Yalcin ◽  
Omer Dizdar ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Elderly Patients ◽  
Cancer Patients ◽  
Systemic Disease ◽  
Performance Status ◽  
The Elderly ◽  
University Hospital ◽  
Individual Treatment ◽  
Pathological Characteristics ◽  
Colorectal Cancer Patients

e14174 Background: Incidence of colon cancer increases with age and generally is diagnosed at the age of between 60-75. Because of comorbidities in elderly patients who are older 70 years of age, lower doses of adjuvant or metastatic therapy is given them or the other option can be the chemotherapeutics which had less side effects. Methods: We aim to identify clinical and pathological characteristics of elderly colorectal cancer patients over 70 years of age who were followed at Baskent University Hospital and compare with CRC patients under the 50 years of age. Results: 182 CRC patients were assigned to the study who were followed between 1998-2011. We classified the patients into two categories according to the age. 91 participants were over 70 years of age and 91 participants were under 50 years of age. There were no significant differences between two groups for gender and percentage of patients having surgery (p=0.65/0.732). History of having systemic disease was significantly higher in the elderly group (p<0.001). Adjvuvant chemotherapy was given to the 38 (53.5%) patients aged over 70 and 66 (91.7%) patients aged under 50 (p<0.001). We compared the both groups for progression free and overall survival time for all stages. However, there were no statistically significant differences between two groups. Conclusions: Our study confirms that elderly CRC patients get benefit from the adjuvant chemotherapy treatment as the same as patients under 50 years of age. Therefore, physcians should consider about performance status and systemic disease in elderly patients and give an individual treatment to them.

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