Chirurgie im hohen Lebensalter

Die Behandlungsbedürftigkeit älterer Patient*innen wird durch den demografischen Wandel kontinuierlich zunehmen. Operationsindikationen bei geriatrischen Patient*innen reichen von Eingriffen zur Verbesserung der Lebensqualität über die Behandlung maligner Erkrankungen bis zu Notfallsituationen wie einer Hohlorganperforation, traumatischen oder ischämischen Ereignissen oder einer Blutung.

Kernaussagen

• Eine umfassende präoperative Evaluierung älterer Patient*innen ist notwendig, um mögliche Risiken zu identifizieren und eine individuell angepasste Behandlungsstrategie zu entwickeln.

• Kalendarisches Alter per se ist kein Ausschlusskriterium in der Chirurgie.

• Die allgemeine Gesundheit der Patient*innen, bestehende Co-Morbiditäten und kognitive Funktionen spielen eine wichtige Rolle bei der präoperativen Einschätzung der Patient*innen.

• Bei guter präoperativer Selektion können auch größere Eingriffe mit guten Kurz- und Langzeitresultaten durchgeführt werden.

• Durch minimalinvasive Operationsverfahren und Regionalverfahren der Anästhesie profitieren auch Risikopatienten von Operationen.

• Postoperativ ist eine Optimierung der Schmerztherapie und frühe Mobilisation unabdingbar.

• Eine individualisierte Herangehensweise und ein ganzheitlicher Blick auf die Patient*innen sind notwendig, um optimale Ergebnisse und eine verbesserte postoperative Genesung zu erzielen.

Schlüsselwörter

Alter - Frailty - Chirurgie - Geriatrie

Publication History

Article published online:
22 March 2024

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