Urologic Laparoscopic Surgeries in Elderly: Analysis of Pre-Operative Risk Factors and Postoperative Complications


Purpose: The aging of the population leads to increases in the prevalence of symptomatic urologic diseases. The aim of this study is the analysis of pre-operative risk factors and postoperative complications in patients over the age of 60 years undergoing elective laparoscopic urologic surgery. Patients and Methods: A retrospective study was conducted of 113 patients 60 years of age or older who underwent urologic laparoscopic surgery by a single surgeon (SP). The preoperative physical status and systemic complications, operation time, postoperative complications, postoperative hospital stay and other clinical features of the patients were reviewed. Complications were classified according to the recently revised Clavien classification system. Statistical analysis was done using Univariate analysis and the Fisher Exact test. Results: Laparoscopic urologic surgery was performed on 113 patients 60 years old and over, with an average age of 69.6 years. Associated diseases were found in 92% of them. Pelvic surgery (65; 57.5%) was the main reason for surgery. There were 5 (4.4%) conversions to open surgery and 0% mortality. The overall complication rate was 10 patients (8.8%). Among 9 (7.96%) patients with post-operative complications; Grade I, II, IIIa, IIIb and IV complications were observed in 1.77%, 12.8%, 3.53%, 0.88% and 0.88% of cases, respectively. Sex with male, operative time ≥ 250 min and cancer had high risk ratio (2.76, 2.11 and 3.02, respectively); however the correlations of all of preoperative risk factors and postoperative complications showed no statistically significant differences. Conclusions: Laparoscopic surgical treatment of urologic disease in elderly patients performed is feasible and well tolerated, with low perioperative morbidity and a good overall survival rate. Pre-operative risk factors may not influence postoperative complications in patients over the age of 60 years undergoing elective laparoscopic urologic surgery.

Share and Cite:

S. Permpongkosol, "Urologic Laparoscopic Surgeries in Elderly: Analysis of Pre-Operative Risk Factors and Postoperative Complications," Open Journal of Urology, Vol. 3 No. 5, 2013, pp. 194-199. doi: 10.4236/oju.2013.35036.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Institute for Population and Social Research MU, “All about Population,” 2009. www.ipsr. mahidol.ac.th
[2] L. C. Zhao, R. A. Rubenstein, I. Y. Vardi, C. Tenggardjaja, N. Smith and R. B. Nadler, “Effect of Advanced Age on Laparoscopic Urologic Procedures,” Journal of Endourology, Vol. 21, No. 1, 2007, pp. 62-64. doi:10.1089/end.2006.9997
[3] R. Ganzer, R. Rabenalt, M. C. Truss, S. Papadoukakis, M. Do, A. Blana, et al., “Evaluation of Complications in Endoscopic Extraperitoneal Radical Prostatectomy in a Modular Training Programme: A Multicentre Experience,” World Journal of Urology, Vol. 26, No. 6, 2008, pp. 587-593. doi:10.1007/ s00345-008-0291-y
[4] D. T. Efron and J. S. Bender, “Laparoscopic Surgery in Older Adults,” Journal of the American Geriatrics Society, Vol. 49, No. 5, 2001, pp. 658-663. doi:10.1046/j.1532-5415.2001.49130.x
[5] M. Harano, M. Eto, A. Yokomizo, K. Tatsugami, M. Hamaguchi and S. Naito, “The Efficacy of Laparoscopic Radical Nephrectomy for Renal Cell Cancer in the Elderly: An Oncological Outcome Analysis,” International Journal of Urology, Vol. 15, No. 7, 2008, pp. 577-581. doi:10.1111/j.1442-2042.2008.02054.x
[6] T. H. Hsu, L. M. Su, L. E. Ratner and L. R. Kavoussi, “Laparoscopic Donor Nephrectomy in the Elderly Patient,” Urology, Vol. 60, No. 3, 2002, pp. 398-401. doi:10.1016/S0090-4295(02)01769-7
[7] F. C. Lai, E. L. Kau C. S. Ng and G. J. Fuchs, “Laparoscopic Nephrectomy Outcomes of Elderly Patients in the 21st Century,” Journal of Endourology, Vol. 21, No. 11, 2007, pp. 1309-1313. doi:10.1089/ end.2007.9885
[8] I. Varkarakis, R. Neururer, T. Harabayashi, G. Bartsch and R. Peschel, “Laparoscopic Radical Nephrectomy in the Elderly,” BJU International, Vol. 94, No. 4, 2004, pp. 517-520. doi:10.1111/j.1464-410X.2004.04994.x
[9] S. Permpongkosol, P. Ungbhakorn and C. Leenanupunth, “Laparo-Endoscopic Single Site (LESS) Management of Benign Kidney Diseases: Evaluation of Complications,” Journal of the Medical Association of Thailand, Vol. 94, No. 1, 2011, pp. 43-49.
[10] S. Permpongkosol, G. C. Lima, C. A. Warlick, M. E. Allaf, I. M. Varkarakis, H. S. Bagga, et al., “Postchemotherapy Laparoscopic Retroperitoneal Lymph Node Dissection: Evaluation of Complications,” Urology, Vol. 69, No. 2, 2007, pp. 361-365. doi:10.1016/j.urology.2006.10.020
[11] S. Permpongkosol, R. E. Link, L. M. Su, F. R. Romero, H. S. Bagga, C. P. Pavlovich, et al., “Complications of 2775 Urological Laparoscopic Procedures: 1993 to 2005,” Journal of Urology, Vol. 177, No. 2, 2007, pp. 580-585. doi:10.1016/j.juro.2006.09.031
[12] G. H. Ballantyne, J. Svahn, R. F. Capella, J. F. Capella, H. J. Schmidt, A. Wasielewski, et al., “Predictors of Prolonged Hospital Stay Following Open and Laparoscopic Gastric Bypass for Morbid Obesity: Body Mass Index, Length of Surgery, Sleep Apnea, Asthma, and the Metabolic Syndrome,” Obesity Surgery, Vol. 14, No. 8, 2004, pp. 1042-1050. doi:10.1381/0960892041975460
[13] D. Dindo, N. Demartines and P. A. Clavien, “Classification of Surgical Complications: A New Proposal with Evaluation in a Cohort of 6336 Patients and Results of a Survey,” Annals of Surgery, Vol. 240, No. 2, 2004, pp. 205-213. doi:10.1097/01.sla.0000133083.54934.ae
[14] J. Dingemann and B. M. Ure, “Systematic Review of Level 1 Evidence for Laparoscopic Pediatric Surgery: Do Our Procedures Comply with the Requirements of Evidence-Based Medicine?” European Journal of Pediatric Surgery, 2013 Feb 26.
[15] R. Vecchio, S. Marchese and E. Intagliata, “Pediatric Laparoscopic Splenectomy in a Department of General Surgery,” Updates in Surgery, 2012 Nov 30.
[16] F. T. Denes, A. Tavares, E. D. Monteiro, J. de Bessa Jr., A. M. Giron, F. A. Queiroz Filho, et al., “Laparoscopic renal Surgery in Infants and Children: Is It a Feasible and Safe Procedure for All Pediatric Age Groups?” International Brazilian Journal of Urology, Vol. 34, No. 6, 2008, pp. 739-746. doi:10.1590/S1677-55382008000600009
[17] J. Majeski, “Laparoscopic Cholecystectomy in Geriatric Patients,” The American Journal of Surgery, Vol. 187, No. 6, 2004, pp. 747-750. doi:10.1016/j.amjsurg.2003.11.031
[18] P. Fornara, C. Doehn and D. Jocham, “Laparoscopic Nephrectomy in Geriatric Patients: Comparison with Conventional Nephrectomy,” Zeitschrift für Gerontologie und Geriatrie, Vol. 33, No. 5, 2000, pp. 388-395. doi:10.1007/s003910070036
[19] J. M. Velasco, V. L. Vallina, D. J. Esposito and S. Theodore, “Laparoscopic Herniorrhaphy in the Geriatric Population,” The American Journal of Surgery, Vol. 64, No. 7, 1998, pp. 633-637.
[20] J. A. Lujan, F. Sanchez-Bueno, P. Parrilla, R. Robles, J. A. Torralba and R. Gonzalez-Costea, “Laparoscopic vs Open Cholecystectomy in Patients Aged 65 and Older,” Surgical Laparoscopy & Endoscopy, Vol. 8, No. 3, 1998, pp. 208-210. doi:10.1097/00019509-199806000-00009
[21] I. Gunka, J. Dostalik, L. Martinek, P. Gunkova, M. Mazur and P. Vavra, “Advanced Age—Indication or Contraindication for Laparoscopic Colorectal Surgery?” Rozhledy v Chirurgii, Vol. 89, No. 10, 2010, pp. 628-633.
[22] M. Burchardt and J. U. Stolzenburg, “Complications in Laparoscopic Urology,” World Journal of Urology, Vol. 26, No. 6, 2008, pp. 521-522. doi:10.1007/s00345-008-0353-1
[23] C. C. Passerotti, H. T. Nguyen, A. B. Retik and C. A. Peters, “Patterns and Predictors of Laparoscopic Complications in Pediatric Urology: The Role of Ongoing Surgical Volume and Access Techniques,” Journal of Urology, Vol. 180, No. 2, 2008, pp. 681-685. doi:10.1016/j.juro.2008.04.042
[24] G. Vallancien, X. Cathelineau, H. Baumert, J. D. Doublet and B. Guillonneau, “Complications of Transperitoneal Laparoscopic Surgery in Urology: Review of 1311 Procedures at a Single Center,” Journal of Urology, Vol. 168, No. 1, 2002, pp. 23-26. doi:10.1016/S0022-5347(05)64823-9
[25] D. M. Gainsburg, “Anesthetic Concerns for Robotic-Assisted Laparoscopic Radical Prostatectomy,” Minerva Anestesiologica, Vol. 78, No. 5, 2012, pp. 596-604.

Copyright © 2024 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.