Is age a contraindication for laporoscopic anti-reflux surgery in elderly

Abstract

Introduction: The aim of this study is to assess the safety of laparoscopic anti-reflux surgery (LARS) in the elderly.

Materials and Method: A total of 1000 patients underwent a LARS procedure between May 2004 and November 2009. Patients over 60 years were defined as group A (A) and under 60 years were defined as group B (B). All data, including demographics, operative details, operative/ postoperative complications and outcomes were recorded in a prospective database.

Results: There were 48 paients in A and 952 patients in B. The mean age of A and B was 64, and 39 respectively.(p<0.0001). Female patients were more frequent in A(60%) opposed to B(37%) (p=0.002). Presence of erozive esophagitis and Barrett metaplasia was 73%, 12% in A, 67%, 8% in B respectively.(p>0.05) Hiatal hernia was more common in A(81%) opposed to B (77%)(p=0.001). Toupet was performed more frequently in A (52%) opposed to B (31%) (p=0.002). There was no mortality and conversion. Esophageal perforation, jejunal perforation and pulmonary emboli were the major complications and were seen only in B(p>0.05). All other minor complications and postoperative dysphagia, bloating and reflux recurrence were similiar among the groups.(p>0.05)

Conclusion: LARS is a safe procedure in patients over 60 years old. Age should not be a contraindication to LARS.