Effect of advanced age on laparoscopic urologic procedures

Purpose: To evaluate the effect of increasing age of urology patients on the outcome of laparoscopic procedures. Patients and Methods: We performed a retrospective review of patients undergoing laparoscopic urologic procedures from 1998 to 2005, comparing patients 75 or older with all other patients undergoing the same procedures. Data were available on 175 patients. Length of hospitalisation, complications, estimated blood loss (EBL), operative time, ASA class, and the Charlson comorbidity index (CCI) were taken from hospital and outpatient records. Subgroup analysis was performed on older patients, one group aged 65 to 74 years and the other ≥75 years. Statistical analysis was done using a two-tailed t-test and chi-square test. Results: Patients aged 75 or older had no statistically significant differences in operative time (318 minutes v 319 minutes; P = 0.967), EBL (271 mL v 331 mL; P = 0.487), or complication rate (14.6% v 12.9%; P = 0.434). However, there was a significant increase in the length of stay (6.06 days v 3.74 days; P = 0.0015). In the subgroup analysis of patients 65 to 74 years v ≥75 years, a significant increase in the length of hospitalization was still present despite controlling for complications. Conclusions: Laparoscopic procedures in patients 75 years and older entail a significantly longer hospital stay than in younger patients despite similar medical comorbidities. Overall, there was no significant increase in perioperative complications related to age.