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Intensivmedizin up2date 2024; 20(01): 105-122
DOI: 10.1055/a-2133-5178
Operative Intensivmedizin

Chirurgie im hohen Lebensalter

Mathilda Knoblauch
,
Thomas Saller
,
Bernhard W. Renz
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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

© 2024. Thieme. All rights reserved.

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