ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2014
Liver resection in the elderly: significance of comorbidities and blood loss.
Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
29 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The Impact of Prehabilitation on Clinical Outcomes in Liver Surgery: A Systematic Review and Meta-Analysis.World journal of surgery · 2026Pooled it
- Trial
- A multicenter case-controlled study on laparoscopic hepatectomy versus open liver resection as first-line therapy for solitary hepatocellular carcinoma in elderly patients.Surgical endoscopy · 2026Article
- Comparison of combined intravenous-inhalation anesthesia and total intravenous anesthesia in perioperative stress and outcomes of elderly patients undergoing hepatectomy.American journal of translational research · 2025Article
- Quantile regression-based prediction of intraoperative blood loss in patients with spinal metastases: model development and validation.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2023Article
- Oncologic Liver Resections in a Geriatric Population: Peri-operative, Long-Term and Quality-of-Life Outcomes-Experience from a High-Volume Centre in India.World journal of surgery · 2023Article
- Safety and benefits of major hepatectomy with extrahepatic bile duct resection in older perihilar cholangiocarcinoma patients.Langenbeck's archives of surgery · 2022Article
- Development and internal validation of the Comprehensive ALPPS Preoperative Risk Assessment (CAPRA) score.Hepatobiliary surgery and nutrition · 2022Article
- Relationship between hepatic venous anatomy and hepatic venous blood loss during hepatectomy.Surgery today · 2021Article
- Impact of Advancing Age on the Status and Risk of Postoperative Infections After Liver Resection.World journal of surgery · 2021Article
- Letter to the Editor: Impact of Ageing on Hepatic Malignancy Resection: Is Age Really a Risk Factor for Mortality?World journal of surgery · 2021Article
- Chemotherapy and Hepatic Steatosis: Impact on Postoperative Morbidity and Survival after Liver Resection for Colorectal Liver Metastases.Visceral medicine · 2021Article
- Relationship between 30 Days Mortality and Incidence of Intraoperative Cardiac Arrest According to the Timing of ECMO.Journal of clinical medicine · 2021Article
- Impact of Ageing on Hepatic Malignancy Resection: Is Age Really a Risk Factor for Mortality?World journal of surgery · 2021Article
- Short- and Long-Term Outcomes After Hepatectomy in Elderly Patients with Hepatocellular Carcinoma: An Analysis of 229 Cases from a Developing Country.Journal of hepatocellular carcinoma · 2021Article
- Prognostic Impact of Pedicle Clamping during Liver Resection for Colorectal Metastases.Cancers · 2020Article
- CD5L-induced activation of autophagy is associated with hepatoprotection in ischemic reperfusion injury via the CD36/ATG7 axis.Experimental and therapeutic medicine · 2020Article
- Risk factors for long-term prognosis of hepatocellular carcinoma patients after anatomic hepatectomy.World journal of clinical cases · 2020Article
- Laparoscopic versus open liver resection for hepatocellular carcinoma in elderly patients: a multi-centre propensity score-based analysis.Surgical endoscopy · 2020Article
- Survival after resection of colorectal liver metastases in octogenarians and sexagenarians compared to their respective age-matched national population.Hepatobiliary surgery and nutrition · 2018Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveLiver resection is increasingly performed in elderly patients who are suspected of increased postoperative morbidity (PM) and reduced overall survival (OS). Patient selection based on the identification of age-adjusted risk factors may help to decrease PM and OS. DESIGN AND
participantsProspectively collected data of 879 patients undergoing elective hepatic resection were analyzed. This population was stratified into three age cohorts: >70 years (n = 228; 26 %), 60-69 years (n = 309; 35 %), and <60 years (n = 342; 39 %). Multivariate survival analysis was performed.
resultsThe incidence of severe (p < 0.01) and non-surgical (p < 0.001) postoperative complications was higher in older compared to younger patients. Major estimated blood loss (EBL; p = 0.039) and comorbidities (p = 0.002) independently increased PM. EBL was comparable between all age cohorts. However, preexisting comorbidities, major EBL, and postoperative complications markedly decreased OS in contrast to younger patients. Adjusted for age, independent predictors of OS were comorbidities (HR = 1.51; p = 0.001), major hepatectomy (HR = 1.33; p = 0.025), increased EBL (HR = 1.32; p = 0.031), and postoperative complications (HR = 1.64; p < 0.001).
conclusionAlthough increased age should not be a contraindication for liver resection, this study accents the avoidance of major blood loss in elderly patients and a stringent patient selection based on preexisting comorbidities.
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