Some Surgeries are Especially Risky for Seniors

A team of researchers created a list of 277 risky procedures for older adults. Considerable’s recent article entitled “These 10 surgeries are considered “uniquely high risk” for older adults” explains that the study, published in JAMA Surgery, generated the list by using admissions data of patients 65 years of age and older. They found 10 surgeries to be especially problematic for older patients:

1. Adrenal gland removal (adrenalectomy). This is the removal of one or both of the adrenal glands. These glands produce hormones that are necessary for daily bodily functions, but tumors can form on the glands and cause increased hormone production. If this happens, the gland(s) needs to be removed. The Cleveland Clinic says the usual recovery time after this surgery is 2-6 weeks, and the risks can include blood clots, infections and high blood pressure.
2. Plaque buildup removal from carotid arteries (carotid endarterectomy). This procedure removes plaque buildup from inside a carotid artery in the neck. This surgery is typically preventative of a stroke and removes blockages that might trigger one. The risks include clotting, stroke or death. However, taking anti-clotting medicines before and after a carotid endarterectomy can decrease these risks.
3. Arm blood-vessel replacement (peripheral vascular bypass surgery). Blood vessel replacement in the arm improves blood flow when an artery becomes narrowed or blocked. A blood vessel from another part of the body or a synthetic blood vessel is used to replace the damaged blood vessel. Risks of this procedure can include irregular heartbeat, infection and death.
4. Abdominal vein resection or replacement. When a blood vessel causes tissue injury in the abdomen, part of the tissue might need to be removed or replaced. Risks include pulmonary embolism, infection and excess bleeding.
5. Varicose vein removal. These veins form in the legs, when the valves in the veins aren’t functioning properly. If a senior is experiencing pain, blood clots, or bleeding, varicose vein removal may be suggested. The risks include nerve injury, heavy bleeding and infection.
6. High gastric bypass. This weight loss surgery alters the way in which the stomach and small intestine handle food. There are a number of criteria that must be met to receive this procedure. It can pose major risks and complications, such as malnutrition, perforation of the stomach or intestines and dumping syndrome (aka when food gets “dumped” directly from the stomach pouch into the small intestine without being digested).
7. Proctopexy (rectal prolapse surgery). Seniors with stool leakage, inability to control their bowel movements (fecal incontinence), or obstructed bowel movements may require a proctopexy. This procedure helps put the rectum back in place. Risks can include damage to nearby nerves and organs, narrowing (stricture) of the anal opening and development of new or worsened constipation.
8. Bile duct excision. When a tumor is blocking the flow of bile to a bile duct, it may be removed. Nausea, jaundice, or a temperature of 101° F (38.3° C) or higher are potential risks of this surgery.
9. A urinary reconstruction technique. Sometimes an individual’s urinary bladder is removed due to cancer, a non-working bladder, or another medical reason. This procedure creates a new way for urine to exit the body when a bladder isn’t present. One risk of the procedure is urine backing up into the kidneys, causing infections, stone formation, or organ damage over time.
10. Ureter repair. If a senior’s ureter is injured (scar tissue forms after an accident or surgery), more surgery might be required to repair it. Chest pain, blood clots and trouble urinating can be complications that follow this procedure.

Reference: Considerable (May 1, 2021) “These 10 surgeries are considered “uniquely high risk” for older adults”