Morbidity and mortality after antireflux and hiatal hernia surgery across a spectrum of ages.

Publication Title

Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract

Document Type

Article

Publication Date

8-1-2024

Keywords

washington; swedish; swedish thoracic surgery; swedish digestive health; swedish cancer

Abstract

BACKGROUND: Antireflux surgery (ARS) and hiatal hernia repair (HHR) are common surgical procedures with modest morbidity. Increasing age is a risk factor for complications; however, details regarding acute morbidity are lacking. This study aimed to describe the incidence rates and types of morbidities across the spectrum of ages.

METHODS: A total of 2342 consecutive cases were retrospectively reviewed from 2003 to 2020 for 30-day complications. All complications were assessed using the Clavien-Dindo (CD) grading system. Patients were divided into 5 age groups: ?59, 60 to 69, 70 to 79, 80 to 89, and ?90 years.

RESULTS: The numbers per age group were 1100 patients aged ?59 years, 684 patients aged 60 to 69 years, 458 patients aged 70 to 79 years, 458 patients aged 80 to 89 years, and 6 patients aged ?90 years. A total of 427 complications (18.2%) occurred, including 2 mortalities, each in the 60- to 69-year age group and the 70- to 79-year age group, for a mortality rate of 0.2%. The complication rate increased from 13.5% (149) in patients aged ?59 years to 35.0% (35) in patients aged ?80 years (P = .006), with CD grades I and II accounting for >70% of complications, except in patients aged ?80 years (57.1%). CD grades IIIa and IIIb were higher in patients aged ?80 years (26.5% [P = .001] and 11.8% [P = .021], respectively). CD grade IVa and IVb complications were rare overall.

CONCLUSION: There is a modest rate of morbidity that increases as patients age, regardless of hernia type, elective or primary surgery, with most being minor complications (CD grade?II). Our data should help patients, referring physicians, and surgeons counsel patients regarding the effect of increasing age in ARS and HHR.

Clinical Institute

Digestive Health

Specialty

Gastroenterology

Specialty

Oncology

Specialty

Swedish Digestive Health Institute

DOI

10.1016/j.gassur.2024.05.033

Link to Full Text

PSJH Full Text

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