Cargando…

Impact of surgical approach on postoperative delirium in elderly patients undergoing gastrectomy: laparoscopic versus open approaches

BACKGROUND: Postoperative delirium is a frequent complication in elderly patients undergoing major abdominal surgery and is associated with a poor outcome. We compared postoperative delirium in elderly patients following laparoscopic gastrectomy (LG) versus open gastrectomy (OG). METHODS: In total,...

Descripción completa

Detalles Bibliográficos
Autores principales: Shin, Young-Hee, Kim, Duk-Kyung, Jeong, Hee-Joon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society of Anesthesiologists 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4524937/
https://www.ncbi.nlm.nih.gov/pubmed/26257851
http://dx.doi.org/10.4097/kjae.2015.68.4.379
_version_ 1782384256452919296
author Shin, Young-Hee
Kim, Duk-Kyung
Jeong, Hee-Joon
author_facet Shin, Young-Hee
Kim, Duk-Kyung
Jeong, Hee-Joon
author_sort Shin, Young-Hee
collection PubMed
description BACKGROUND: Postoperative delirium is a frequent complication in elderly patients undergoing major abdominal surgery and is associated with a poor outcome. We compared postoperative delirium in elderly patients following laparoscopic gastrectomy (LG) versus open gastrectomy (OG). METHODS: In total, 130 patients aged ≥ 65 years with gastric cancer undergoing LG and OG were enrolled prospectively. Postoperative delirium and cognitive status were assessed daily using the Confusion Assessment Method (CAM) and Mini-Mental Status Examination (MMSE), respectively, for 3 days postoperatively. For CAM-positive patients, delirium severity was then assessed using the Delirium Index (DI). RESULTS: In total, 123 subjects (LG, n = 60; OG, n = 63) were included in the analysis. In both groups, the overall incidences of postoperative delirium were similar: 31.6% (19/60) in the LG group and 41.2% (26/63) in the OG group. When considering only those with delirium, the severity, expressed as the highest DI score, was similar between the groups. A decline in cognitive function (reduction in MMSE ≥ 2 points from baseline) during 3 days postoperatively was observed in 23 patients in the LG group (38.3%) and 27 patients in the OG group (42.9%) (P = 0.744). In both groups, postoperative cognitive decline was significantly associated with postoperative delirium (P < 0.001). CONCLUSIONS: We found that, compared with traditional open gastrectomy, laparoscopic gastrectomy did not reduce either postoperative delirium or cognitive decline in elderly patients with gastric cancer.
format Online
Article
Text
id pubmed-4524937
institution National Center for Biotechnology Information
language English
publishDate 2015
publisher The Korean Society of Anesthesiologists
record_format MEDLINE/PubMed
spelling pubmed-45249372015-08-07 Impact of surgical approach on postoperative delirium in elderly patients undergoing gastrectomy: laparoscopic versus open approaches Shin, Young-Hee Kim, Duk-Kyung Jeong, Hee-Joon Korean J Anesthesiol Clinical Research Article BACKGROUND: Postoperative delirium is a frequent complication in elderly patients undergoing major abdominal surgery and is associated with a poor outcome. We compared postoperative delirium in elderly patients following laparoscopic gastrectomy (LG) versus open gastrectomy (OG). METHODS: In total, 130 patients aged ≥ 65 years with gastric cancer undergoing LG and OG were enrolled prospectively. Postoperative delirium and cognitive status were assessed daily using the Confusion Assessment Method (CAM) and Mini-Mental Status Examination (MMSE), respectively, for 3 days postoperatively. For CAM-positive patients, delirium severity was then assessed using the Delirium Index (DI). RESULTS: In total, 123 subjects (LG, n = 60; OG, n = 63) were included in the analysis. In both groups, the overall incidences of postoperative delirium were similar: 31.6% (19/60) in the LG group and 41.2% (26/63) in the OG group. When considering only those with delirium, the severity, expressed as the highest DI score, was similar between the groups. A decline in cognitive function (reduction in MMSE ≥ 2 points from baseline) during 3 days postoperatively was observed in 23 patients in the LG group (38.3%) and 27 patients in the OG group (42.9%) (P = 0.744). In both groups, postoperative cognitive decline was significantly associated with postoperative delirium (P < 0.001). CONCLUSIONS: We found that, compared with traditional open gastrectomy, laparoscopic gastrectomy did not reduce either postoperative delirium or cognitive decline in elderly patients with gastric cancer. The Korean Society of Anesthesiologists 2015-08 2015-07-28 /pmc/articles/PMC4524937/ /pubmed/26257851 http://dx.doi.org/10.4097/kjae.2015.68.4.379 Text en Copyright © the Korean Society of Anesthesiologists, 2015 http://creativecommons.org/licenses/by-nc/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Research Article
Shin, Young-Hee
Kim, Duk-Kyung
Jeong, Hee-Joon
Impact of surgical approach on postoperative delirium in elderly patients undergoing gastrectomy: laparoscopic versus open approaches
title Impact of surgical approach on postoperative delirium in elderly patients undergoing gastrectomy: laparoscopic versus open approaches
title_full Impact of surgical approach on postoperative delirium in elderly patients undergoing gastrectomy: laparoscopic versus open approaches
title_fullStr Impact of surgical approach on postoperative delirium in elderly patients undergoing gastrectomy: laparoscopic versus open approaches
title_full_unstemmed Impact of surgical approach on postoperative delirium in elderly patients undergoing gastrectomy: laparoscopic versus open approaches
title_short Impact of surgical approach on postoperative delirium in elderly patients undergoing gastrectomy: laparoscopic versus open approaches
title_sort impact of surgical approach on postoperative delirium in elderly patients undergoing gastrectomy: laparoscopic versus open approaches
topic Clinical Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4524937/
https://www.ncbi.nlm.nih.gov/pubmed/26257851
http://dx.doi.org/10.4097/kjae.2015.68.4.379
work_keys_str_mv AT shinyounghee impactofsurgicalapproachonpostoperativedeliriuminelderlypatientsundergoinggastrectomylaparoscopicversusopenapproaches
AT kimdukkyung impactofsurgicalapproachonpostoperativedeliriuminelderlypatientsundergoinggastrectomylaparoscopicversusopenapproaches
AT jeongheejoon impactofsurgicalapproachonpostoperativedeliriuminelderlypatientsundergoinggastrectomylaparoscopicversusopenapproaches