EP378/#781 Advantages of laparoscopy in gynecologic surgery in elderly patients. (4th December 2022)

• Record Type: Journal Article
• Authors: Chang, Chi-Son; Jang, Il-Yeo; Jeon, Jungeun; Jung, Jihee; Lee, Yoo-Young; Kim, Tae-Joong; Lee, Jeong-Won; Kim, Byoung-Gie; Choi, Chel Hun
• Is Part Of: International journal of gynecological cancer. Volume 32(2022)Supplement 3
• Page Start: A207
• Page End: A207
• Publication Date: 2022-12-04
• Subjects: Generative organs, Female -- Cancer -- Periodicals; 616.99465
• DOI: 10.1136/ijgc-2022-igcs.467
• Languages: English
• ISSNs: 1048-891X

Abstract

Abstract : Objectives: Older patients are at a higher risk for postoperative morbidity and mortality compared to younger patients. Laparoscopic surgery has been widely used as a minimally invasive method to reduce postoperative morbidity. However, it is prone to higher cardiopulmonary morbidity in elderly patients. So, we compared surgical outcomes of open and laparoscopic gynecologic surgeries in elderly patients. Methods: This study included patients who received gynecologic surgery at over 55 years of age from 2010 to 2020. Surgeries with vaginal approach and operations for ovarian cancer were excluded. Surgical outcomes were compared between the open surgery and laparoscopy group. To consider age, the age cut-off was set as 65 which showed the most discriminative power in surgical outcomes between the younger and older groups. Results: Among 2983 patients, 28.6% underwent open surgery and 71.4% underwent laparoscopic surgery. In both young and elderly groups, the perioperative outcomes of laparoscopic surgery were better than those of the open surgery. In both open and laparoscopic surgery groups, patients older than 65 showed overall worse surgical outcomes. However, the age-related difference in the perioperative outcomes was less severe in the laparoscopy group. In linear regression analysis, the differences in EBL, transfusion, and hospital days between the younger and older groups were smaller in laparoscopy than in open surgery. Conclusions: Although the surgical outcome was worse in the older patients, the difference between the age groups was smaller when surgery was performed with laparoscopy. Laparoscopic gynecologic surgery offers more advantages and safety in elderly patients over 65 years of age.