Outcomes in an octogenarian cohort - a retrospective analysis of 15 years of laparoscopic nephrectomies within a regional centre
BAUS ePoster online library. Norton S.
Jun 27, 2018; 211386
Ms. Sarah Norton
Ms. Sarah Norton
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Abstract
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Introduction: Laparoscopic nephrectomy is the gold standard for renal malignancies not amenable to nephron sparing surgery. With an ageing population and increased use of imaging modalities, the incidence of renal malignancies detected in the elderly has risen. Yet most cohort studies only represent a small number of octogenarians. We aimed to report our fifteen-year experience of performing laparoscopic nephrectomy in the elderly (≥80yrs), and compare their morbidity to younger patients.

Patients and Methods: All laparoscopic nephrectomies performed across three institutions in a regional centre over 15 years from 1/06/2001 to 31/6/2016 were identified through medical coding. Chart reviews were completed with documentation of age, BMI, operative details including indication, blood loss and operative time. Post-operative complications were graded according to the Clavien system. We excluded pyeloplasties, partial, open or those converted to open nephrectomies.

Results: We identified 388 patients of median age 65yrs (IQR53-74), of which 48 were octogenarians (≥80yrs). No patients underwent renal mass biopsy. The numbers of benign pathologies were not different between the two cohorts. Aside from age, no differences were apparent in BMI (28 vs 28). Renal mass biopsies were not performed on any patients. No statistically significant differences were identified between octogenarians and non-octogenarians in operative length (197mins vs 200), blood loss (197 vs 200mLs), complication rates (56% vs 38%, p 0.011) and length of hospital stay (5 vs 5 days).

Conclusions: Our findings suggest that when octogenerians undergo laparoscopic nephrectomy, operative characteristics, length of stay and complications rates are comparable to their younger counterparts.
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