Minimally invasive laparoscopic surgery purportedly eases the operative burden on patients by lessening incisional pain, decreasing narcotic use, improving post-operative respiratory function, allowing earlier mobility and resulting in shorter periods of hospitalization.

In order to assess these factors, Dr. S. F. Matin and colleagues of Cleveland Ohio retrospectively reviewed the courses of 399 patients who underwent various types of laparoscopic nephrectomy or adrenalectomy. Of these, 207 (52%) were over 65 years in age. They reported their studies in the October 2003 edition of the Journal of Urology.

Along with age, they performed risk classification according to the American Society of Anesthesiologists (ASA) score, and by use of the Charlson Index. Each method conveniently allowed segregation of the age groups into those with score or index <3, 3 or >3. Other operative parameters contributed to their analysis.

They found no correlations between age >65 and any increased incidence of postoperative complications. Such patients did on the average, however, remain in the hospital about one day longer than those <65 years age. They also noted that larger estimated blood losses (EBL) and need for transfusion (which incidentally correlated with longer operative duration) led to a significantly greater occurrence of post-operative complications.

Higher ASA scores predicted greater likelihood of need for transfusion, and higher Charlson indices predicted increased risk of postoperative complications.

In conclusion, they state that ??age 65 years or older is not a significant independent predictor of adverse outcomes after laparoscopic surgery?. However, patients with Charlson indices >3 did have more complications, and those with ASA scores >3 did require more blood transfusions.

J Urol 2003;170:1115-1120