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Liver resection versus ablation in geriatric populations - Does one method impart improved in-hospital mortality?
Gajdos, Csaba; Ryan, Carrie; Savulionyte, Goda; Schwaitzberg, Steven; Nader, Nader.
Afiliación
  • Gajdos C; Department of Surgery, Buffalo University Jacobs School of Medicine and Biomedical Sciences, Buffalo, USA.
  • Ryan C; Department of Surgery, Buffalo University Jacobs School of Medicine and Biomedical Sciences, Buffalo, USA.
  • Savulionyte G; Department of Surgery, Buffalo University Jacobs School of Medicine and Biomedical Sciences, Buffalo, USA.
  • Schwaitzberg S; Department of Surgery, Buffalo University Jacobs School of Medicine and Biomedical Sciences, Buffalo, USA.
  • Nader N; Department of Anesthesiology, Buffalo University Jacobs Faculty of Medicine and Biomedical Scinces, Buffalo, USA.
Turk J Surg ; 40(1): 47-53, 2024 Mar.
Article en En | MEDLINE | ID: mdl-39035997
ABSTRACT

Objectives:

This study aimed to compare surgical resection versus ablation for managing liver malignancies in patients 65 and older. Material and

Methods:

Cases with liver tumors were extracted from the NSQIP database for patients aged ≥65 years. Following propensity score matching, multivariate Cox regression was used for 30-day morbidity and mortality for liver resection and ablation.

Results:

Following a propensity score matching, 1048 patients were 11 matched for comorbid conditions. Patients stayed in the hospital three days longer after resection (p<0.001). Mortality was lower after ablation (p= 0.013). This difference was more prominent in patients with primary liver tumors (p= 0.008). Group A had a 10-fold lower risk of developing an abdominal abscess, a fourfold decrease in hospital-associated pneumonia (p= 0.001) and reintubation, a 10-fold reduction in bleeding requiring transfusion (p<0.001), and a three-fold decrease in risk of developing sepsis (p<0.001).

Conclusion:

Despite being a generally sicker patient population with worse underlying liver function, ablative techniques were associated with a lower risk of adverse outcomes when compared to more aggressive resection of primary malignant tumors of the liver.
Palabras clave

Texto completo: 1 Base de datos: MEDLINE Idioma: En Revista: Turk J Surg Año: 2024 Tipo del documento: Article

Texto completo: 1 Base de datos: MEDLINE Idioma: En Revista: Turk J Surg Año: 2024 Tipo del documento: Article