Gibt es ein Alterslimit für chirurgische Maßnahmen?

Zusammenfassung

Die demografische Entwicklung bedingt zwangsläufig eine Zunahme älterer Patienten (> 70 Jahre), die chirurgische Maßnahmen benötigen. Mittlerweile werden auch große chirurgische Eingriffe bei hochbetagten Patienten mit guten Ergebnissen durchgeführt. Auch radikale onkologische Operationen machen im hohen Lebensalter angesichts einer immer höheren Lebenserwartung Sinn. Während das kalendarische Lebensalter selbst kein Risikofaktor für perioperative Komplikationen ist und daher kein Alterslimit für chirurgische Maßnahmen existiert, können die im Alter in hoher Frequenz vorhandenen Komorbiditäten und die eingeschränkten funktionellen Reserven das Operationsrisiko massiv erhöhen. Insofern muss für den einzelnen Patienten eine individuelle Abwägung der Vor- und Nachteile einer chirurgischen Maßnahme erfolgen. Ein spezialisiertes geriatrisches Assessment und ein optimales perioperatives Management des alten Patienten können die Ergebnisse einer chirurgischen Therapie verbessern.

Abstract

The demographic development leads to an increase of elderly patients (> 70 years) who require surgical interventions. Nowadays, even complex surgical interventions are performed with good results in very old patients. In view of an increasing life expectancy, radical oncological surgery makes sense even in high age. High age itself is not a risk factor for perioperative morbidity and mortality, and therefore there is no age limit for surgical interventions. However, comorbidities are more frequent in old patients, and these can massively increase the risk of surgery. Thus, for the individual patient, pros and cons of surgical interventions have to be weighed up. A specialised geriatric assessment and an optimal perioperative management of the old patient can improve the results of surgical therapy.

Schlüsselwörter

Chirurgie im Alter - Demografie - Alter - Geriatrie

Key words

surgery for the elderly - demography - age - geriatric medicine

• Literatur

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