Elderly patients can be effectively and safely treated with minimally invasive antireflux surgery for gastroesophageal reflux (GERD). However, data describing the influence of advanced age on long-term quality of life (QoL) and perioperative outcomes after laparoscopic antireflux surgery (LARS) are very few.

A group of researchers conducted a retrospective study of patients undergoing LARS at a single institution. The patients were divided into four age categories, with their perioperative data and quality of life (QOL) outcomes collected for analysis. Four age-determined subgroups were created to accommodate all the patients (<50:75, 50-65:179, 65-75:144, ≥ 75:94). The final analysis comprised a total of 492 patients, with a mean follow-up of 21 months post-surgery. 

Advancing age was found to be directly proportional to the likelihood of comorbid disease. The need for Collis gastroplasty (OR 2.09) or concurrent gastropexy (OR 3.20) was found to be more likely in the elderly. The older patients were more likely to undergo longer surgeries and experience longer hospitalization. Intraoperative complications and reoperations were commonly seen in older surgical patients. However, postoperative QoL outcomes and complication rates were similar among all age groups. Thus it was concluded that the older patients are at a greater risk of intraoperative complications, reoperation rates, longer operative time and LOS after LARS. But they enjoy a long-term QoL benefit after undergoing this procedure. So, instead of serving as an exclusion criterion for surgical intervention, advanced age among chronic reflux patients should instead represent a comorbidity and must be kept in mind while planning the surgery.

Addo A, et al.  Surg Endosc. 2021 Jan;35(1):429-436.