The number of liver resections in patients over 70 is increasing due to demographic changes and longer life expectancy, particularly in industrialized countries. It is well established that greater age is related to increased postoperative morbidity and death after general anesthetic surgery. For a study, researchers sought to examine the postoperative outcome of liver resections for malignancies in individuals under and over the age of 70.
A prospectively collected computerized database of 1,034 liver resections between January 2013 and December 2019 was evaluated retrospectively. A study of individuals aged 70 and 70 who had liver resections for cancer included 889 surgeries on 703 participants. In addition, there was a postoperative outcome analysis and univariate and multivariate assessments of related risk variables.
The overall cohort’s median age was 65 years (range 18-87 years). About N=582 liver resections (65.7%) were done in patients 70 years or younger, with 42.8% major hepatectomies, and n = 307 (34.3%) liver resections in patients 70 years or older, with 50.5% major hepatectomies (P=0.034). The overall cohort’s relevant postoperative morbidity was 27.9%. The 30-day death rate was 3.9%, with a 14.8% re-operation rate. Patients 70 years and older exhibited considerably greater postoperative morbidity and death rates than patients 70 years and younger. Major resections, longer operating times, blood product and biliodigestive anastomosis (BDA) transfusions, and inferior vena cava (IVC) resection were all independent risk factors for poor postoperative outcome.
Liver resections in individuals above 70 are associated with a poorer postoperative course. In these cases, parenchyma-sparing resections should be favored.
Reference: sciencedirect.com/science/article/abs/pii/S1743919122005064
