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Surgical Management of Elderly Patients pp 31–46Cite as

Principles of Geriatric Surgery

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Abstract

Geriatric surgery is the branch of medicine concerned with the surgical care of older adults. As people grow older, age-related biological parameters diverge, whereas they tend to converge toward a narrower range of mean values in the young. Aging is a physiological, genetically programmed, universal, and heterochronic process. At this stage of older age, an elderly person’s sociofunctional status can be classified from robust to frail (fit, pre-frail, frail). In geriatric surgery, successful patient outcome is not so much the result of a surgical technique as it is a deep understanding of the geriatric patient. Since the functional reserve of vital organs diminishes with increasing age, chronological age constitutes a risk factor in itself. Two other common risk factors in the elderly are the immobilization syndrome and malnutrition, both of which are more often present in institutionalized patients. These risk factors place the elderly in a precarious situation of distress. Distressing symptoms are associated with psychophysical and emotional decline and frailty, which is one of the hallmark characteristics of high-risk elderly surgical patients. Closely linked to frailty is delirium, usually but not always occurring during the postoperative period, which significantly diminishes the quality of life of older adults.

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Notes

  1. 1.

    The authors wish to thank Dr. Marco Tinivella, Head of Dietary and Clinical Nutrition Service, San Luigi Gonzaga Hospital, for critical review of this section.

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Authors and Affiliations

  1. Full Professor of General Surgery—Honorary President of the Italian Society of Geriatric Surgery, Orbassano, Turin, Italy

    Mario Nano

  2. University of Turin, Aggregate Professor San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy

    Mario Solej

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  1. Mario Nano
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  2. Mario Solej
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  1. Department of General and Mininvasive Surgery, Cristo Re Hospital, Rome, Italy

    Antonio Crucitti

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Nano, M., Solej, M. (2018). Principles of Geriatric Surgery. In: Crucitti, A. (eds) Surgical Management of Elderly Patients. Springer, Cham. https://doi.org/10.1007/978-3-319-60861-7_3

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  • DOI: https://doi.org/10.1007/978-3-319-60861-7_3

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