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Current Treatment Options in Gastroenterology

Erschienen in:

21.11.2019 | Gastroenterology for Geriatric Patients (S Katz and A Afzali, Section Editors)

Special Considerations for Colorectal Surgery in the Elderly IBD Patient

verfasst von: Amy L. Lightner, MD, Miguel Regueiro, MD, Benjamin Click, MD

Erschienen in: Current Treatment Options in Gastroenterology | Ausgabe 4/2019

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Abstract

Purpose of review

We sought to understand the key aspects to optimize in the perioperative period when treating an elderly surgical patient with inflammatory bowel disease.

Recent findings

Addressing preoperative polypharmacy, frailty, and nutrition is important in the elderly population. Understanding intraoperative principles of oncologic risk and pouch formation and the advantages of laparoscopy are key. Postoperative-enhanced recovery pathways and VTE prophylaxis are essential for high-quality care.

Summary

Preoperative, perioperative, and postoperative factors can greatly impact elderly patients’ surgical outcomes.

Molodecky NA, Soon IS, Rabi DM, et al. Increasing incidence and prevalence of the inflammatory bowel diseases with time, based on systematic review. Gastroenterology. 2012;142(1):46–54 e42 quiz e30.

Kelsen J, Baldassano RN. Inflammatory bowel disease: the difference between children and adults. Inflamm Bowel Dis. 2008;14(Suppl 2):S9–11.PubMed

Gower-Rousseau C, Vasseur F, Fumery M, et al. Epidemiology of inflammatory bowel diseases: new insights from a French population-based registry (EPIMAD). Dig Liver Dis. 2013;45(2):89–94.PubMed

Ananthakrishnan AN, Binion DG. Treatment of ulcerative colitis in the elderly. Dig Dis. 2009;27(3):327–34.PubMed

Lakatos PL, David G, Pandur T, et al. IBD in the elderly population: results from a population-based study in Western Hungary, 1977-2008. J Crohns Colitis. 2011;5(1):5–13.PubMed

• Everhov AH, Halfvarson J, Myrelid P, et al. Incidence and treatment of patients diagnosed with inflammatory bowel diseases at 60 years or older in Sweden. Gastroenterology. 2018;154(3):518–528 e515 Approximately one quarter of patients are diagnosed with inflammatory bowel disease over the age of 60. Elderly patients are at a higher risk of a bowel resection than non-elderly. PubMed

Juneja M, Baidoo L, Schwartz MB, et al. Geriatric inflammatory bowel disease: phenotypic presentation, treatment patterns, nutritional status, outcomes, and comorbidity. Dig Dis Sci. 2012;57(9):2408–15.PubMed

Arnoldo L, Cattani G, Cojutti P, Pea F, Brusaferro S. Monitoring polypharmacy in healthcare systems through a multi-setting survey: should we put more attention on long term care facilities? J Public Health Res. 2016;5(3):745.PubMedPubMedCentral

Gnjidic D, Hilmer SN, Blyth FM, et al. Polypharmacy cutoff and outcomes: five or more medicines were used to identify community-dwelling older men at risk of different adverse outcomes. J Clin Epidemiol. 2012;65(9):989–95.PubMed

10.

Fried TR, O’Leary J, Towle V, Goldstein MK, Trentalange M, Martin DK. Health outcomes associated with polypharmacy in community-dwelling older adults: a systematic review. J Am Geriatr Soc. 2014;62(12):2261–72.PubMedPubMedCentral

11.

Jeong YM, Lee E, Kim KI, et al. Association of pre-operative medication use with post-operative delirium in surgical oncology patients receiving comprehensive geriatric assessment. BMC Geriatr. 2016;16:134.PubMedPubMedCentral

12.

McIsaac DI, Wong CA, Bryson GL, van Walraven C. Association of polypharmacy with survival, complications, and healthcare resource use after elective noncardiac surgery: a population-based cohort study. Anesthesiology. 2018;128(6):1140–50.PubMed

13.

Ananthakrishnan AN, McGinley EL, Binion DG. Inflammatory bowel disease in the elderly is associated with worse outcomes: a national study of hospitalizations. Inflamm Bowel Dis. 2009;15(2):182–9.PubMed

14.

Bassi A, Dodd S, Williamson P, Bodger K. Cost of illness of inflammatory bowel disease in the UK: a single centre retrospective study. Gut. 2004;53(10):1471–8.PubMedPubMedCentral

15.

Odes S, Vardi H, Friger M, et al. Cost analysis and cost determinants in a European inflammatory bowel disease inception cohort with 10 years of follow-up evaluation. Gastroenterology. 2006;131(3):719–28.PubMed

16.

Farrokhyar F, Swarbrick ET, Irvine EJ. A critical review of epidemiological studies in inflammatory bowel disease. Scand J Gastroenterol. 2001;36(1):2–15.PubMed

17.

Loftus EV Jr. A matter of life or death: mortality in Crohn’s disease. Inflamm Bowel Dis. 2002;8(6):428–9.PubMed

18.

Wolters FL, Russel MG, Sijbrandij J, et al. Phenotype at diagnosis predicts recurrence rates in Crohn’s disease. Gut. 2006;55(8):1124–30.PubMedPubMedCentral

19.

Robinson TN, Walston JD, Brummel NE, et al. Frailty for surgeons: review of a National Institute on aging conference on frailty for specialists. J Am Coll Surg. 2015;221(6):1083–92.PubMedPubMedCentral

20.

Fried LP, Tangen CM, Walston J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):M146–56.PubMed

21.

Rockwood K, Mitnitski A. Frailty in relation to the accumulation of deficits. J Gerontol A Biol Sci Med Sci. 2007;62(7):722–7.PubMed

22.

Farhat JS, Velanovich V, Falvo AJ, et al. Are the frail destined to fail? Frailty index as predictor of surgical morbidity and mortality in the elderly. J Trauma Acute Care Surg. 2012;72(6):1526–30 discussion 1530-1521.PubMed

23.

Velanovich V, Antoine H, Swartz A, Peters D, Rubinfeld I. Accumulating deficits model of frailty and postoperative mortality and morbidity: its application to a national database. J Surg Res. 2013;183(1):104–10.PubMed

24.

Lin HS, Watts JN, Peel NM, Hubbard RE. Frailty and post-operative outcomes in older surgical patients: a systematic review. BMC Geriatr. 2016;16(1):157.PubMedPubMedCentral

25.

•• Hall DE, Arya S, Schmid KK, et al. Association of a frailty screening initiative with postoperative survival at 30, 180, and 365 days. JAMA Surg. 2017;152(3):233–40 Screening for frailty resulted in reduced mortality. This underscores the importance of evaluating and then improving frailty prior to surgical intervention.

26.

Chow WB, Rosenthal RA, Merkow RP, et al. Optimal preoperative assessment of the geriatric surgical patient: a best practices guideline from the American College of Surgeons National Surgical Quality Improvement Program and the American Geriatrics Society. J Am Coll Surg. 2012;215(4):453–66.PubMed

27.

Tarazona-Santabalbina FJ, Gomez-Cabrera MC, Perez-Ros P, et al. A multicomponent exercise intervention that reverses frailty and improves cognition, emotion, and social networking in the community-dwelling frail elderly: a randomized clinical trial. J Am Med Dir Assoc. 2016;17(5):426–33.PubMed

28.

Landi F, Cesari M, Calvani R, et al. The “Sarcopenia and Physical fRailty IN older people: multi-componenT Treatment strategies” (SPRINTT) randomized controlled trial: design and methods. Aging Clin Exp Res. 2017;29(1):89–100.PubMed

29.

Carli F, Scheede-Bergdahl C. Prehabilitation to enhance perioperative care. Anesthesiol Clin. 2015;33(1):17–33.PubMed

30.

Minnella EM, Bousquet-Dion G, Awasthi R, Scheede-Bergdahl C, Carli F. Multimodal prehabilitation improves functional capacity before and after colorectal surgery for cancer: a five-year research experience. Acta Oncol. 2017;56(2):295–300.PubMed

31.

Braude P, Goodman A, Elias T, et al. Evaluation and establishment of a ward-based geriatric liaison service for older urological surgical patients: Proactive care of Older People undergoing Surgery (POPS)-Urology. BJU Int. 2017;120(1):123–9.PubMed

32.

Harari D, Hopper A, Dhesi J, Babic-Illman G, Lockwood L, Martin F. Proactive care of older people undergoing surgery (‘POPS’): designing, embedding, evaluating and funding a comprehensive geriatric assessment service for older elective surgical patients. Age Ageing. 2007;36(2):190–6.PubMed

33.

McClave SA, Kozar R, Martindale RG, et al. Summary points and consensus recommendations from the North American Surgical Nutrition Summit. JPEN J Parenter Enteral Nutr. 2013;37(5 Suppl):99S–105S.PubMed

34.

Mohanty S, Rosenthal RA, Russell MM, Neuman MD, Ko CY, Esnaola NF. Optimal perioperative management of the geriatric patient: a best practices guideline from the American College of Surgeons NSQIP and the American Geriatrics Society. J Am Coll Surg. 2016;222(5):930–47.PubMed

35.

Gupta R, Gan TJ. Preoperative nutrition and prehabilitation. Anesthesiol Clin. 2016;34(1):143–53.PubMed

36.

Volkert D, Berner YN, Berry E, et al. ESPEN Guidelines on enteral nutrition: geriatrics. Clin Nutr. 2006;25(2):330–60.PubMed

37.

Smith MD, McCall J, Plank L, Herbison GP, Soop M, Nygren J. Preoperative carbohydrate treatment for enhancing recovery after elective surgery. Cochrane Database Syst Rev. 2014;8:CD009161.

38.

Wanders LK, Dekker E, Pullens B, Bassett P, Travis SP, East JE. Cancer risk after resection of polypoid dysplasia in patients with longstanding ulcerative colitis: a meta-analysis. Clin Gastroenterol Hepatol. 2014;12(5):756–64.PubMed

39.

Beaugerie L, Svrcek M, Seksik P, et al. Risk of colorectal high-grade dysplasia and cancer in a prospective observational cohort of patients with inflammatory bowel disease. Gastroenterology. 2013;145(1):166–175. e168.PubMed

40.

Jess T, Loftus EV Jr, Velayos FS, et al. Risk factors for colorectal neoplasia in inflammatory bowel disease: a nested case-control study from Copenhagen county, Denmark and Olmsted county. Minnesota. Am J Gastroenterol. 2007;102(4):829–36.PubMed

41.

Taleban S, Colombel JF, Mohler MJ, Fain MJ. Inflammatory bowel disease and the elderly: a review. J Crohns Colitis. 2015;9(6):507–15.PubMed

42.

Khan N, Vallarino C, Lissoos T, Darr U, Luo M. Risk of malignancy in a nationwide cohort of elderly inflammatory bowel disease patients. Drugs Aging. 2017;34(11):859–68.PubMedPubMedCentral

43.

Burisch J, Munkholm P. The epidemiology of inflammatory bowel disease. Scand J Gastroenterol. 2015;50(8):942–51.PubMed

44.

Delaney CP, Fazio VW, Remzi FH, et al. Prospective, age-related analysis of surgical results, functional outcome, and quality of life after ileal pouch-anal anastomosis. Ann Surg. 2003;238(2):221–8.PubMedPubMedCentral

45.

Dignass A, Lindsay JO, Sturm A, et al. Second European evidence-based consensus on the diagnosis and management of ulcerative colitis part 2: current management. J Crohns Colitis. 2012;6(10):991–1030.PubMed

46.

Cohen JL, Strong SA, Hyman NH, et al. Practice parameters for the surgical treatment of ulcerative colitis. Dis Colon Rectum. 2005;48(11):1997–2009.PubMed

47.

Katz S, Feldstein R. Inflammatory bowel disease of the elderly: a wake-up call. Gastroenterol Hepatol (N Y). 2008;4(5):337–47.

48.

Church JM. Functional outcome and quality of life in an elderly patient with an ileal pouch-anal anastomosis: a 10-year follow up. Aust N Z J Surg. 2000;70(12):906–7.PubMed

49.

Delaney CP, Dadvand B, Remzi FH, Church JM, Fazio VW. Functional outcome, quality of life, and complications after ileal pouch-anal anastomosis in selected septuagenarians. Dis Colon Rectum. 2002;45(7):890–4 discussion 894.

50.

Schwandner O, Schiedeck TH, Bruch HP. Advanced age--indication or contraindication for laparoscopic colorectal surgery? Dis Colon Rectum. 1999;42(3):356–62.PubMed

51.

Seshadri PA, Mamazza J, Schlachta CM, Cadeddu MO, Poulin EC. Laparoscopic colorectal resection in octogenarians. Surg Endosc. 2001;15(8):802–5.PubMed

52.

Grailey K, Markar SR, Karthikesalingam A, Aboud R, Ziprin P, Faiz O. Laparoscopic versus open colorectal resection in the elderly population. Surg Endosc. 2013;27(1):19–30.PubMed

53.

Mutch MG. Laparoscopic colectomy in the elderly: when is too old? Clin Colon Rectal Surg. 2006;19(1):33–9.PubMedPubMedCentral

54.

Ljungqvist O, Scott M, Fearon KC. Enhanced recovery after surgery: a review. JAMA Surg. 2017;152(3):292–8.PubMed

55.

Harper PC, McAuliffe TL, Beeken WL. Crohn’s disease in the elderly. A statistical comparison with younger patients matched for sex and duration of disease. Arch Intern Med. 1986;146(4):753–5.PubMed

Titel: Special Considerations for Colorectal Surgery in the Elderly IBD Patient
verfasst von: Amy L. Lightner, MD
Miguel Regueiro, MD
Benjamin Click, MD
Publikationsdatum: 21.11.2019
Verlag: Springer US
Erschienen in: Current Treatment Options in Gastroenterology / Ausgabe 4/2019
Print ISSN: 1092-8472
Elektronische ISSN: 1534-309X
DOI: https://doi.org/10.1007/s11938-019-00254-1

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Special Considerations for Colorectal Surgery in the Elderly IBD Patient

Abstract

Purpose of review

Recent findings

Summary

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Purpose of review

Recent findings

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