Apr 16 2007
Quite simply, in any laparoscopic procedure there are two factors, the surgeon and the patient.
A good surgeon performs an equally high quality procedure in all patients regardless of age; hence in this study, patients > 75 yrs. (31 cases) had similar operative times, complication rates and blood loss compared with 144 patients aged 15-74 yrs. However, with age, people recover less quickly whether it is from athletic endeavors or "intervention". Hence, the authors noted that the patients > 75 yrs. had an increased hospital stay (6.1 days vs. 3.7 days p = 0.0015). These are important data for two reasons: the benefits of laparoscopy can be safely extended to the older patient; however, insurance carriers and urologists need to realize that the standard post laparoscopic hospital stays allowed for our senior citizens need to be upward of 3 days longer than for younger patients. To be sure, my experience is similar to that of the authors; at our institution, it would seem that in the septuagenarian and octogenarian, slowness in return to bowel function plays an important role in this lengthened stay.
L. C. Zhao, R. A. Rubenstein, I. Y. Vardi, C. Tenggardjaja, N. Smith, and R. B. Nadler
Journal of Endourology 21(1): 62- 64, January 2007
By Ralph V. Clayman, MD
Hospital privatization leads to lower quality care, study reveals