Artikel
Meningioma surgery in the elderly
Meningeomchirurgie bei betagten Patienten
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Autoren
Veröffentlicht: | 23. April 2004 |
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Gliederung
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Objective
To retrospectively analyze outcome and risk of surgery in geriatric patients with intracranial meningiomas.
Methods
We analysed 37 consecutive patients older than 65 years suffering from an intracranial meningioma, who were operated upon between 2000 and 2002. Average age was 72 years ( 65 to 85 years). All patients were treated by microsurgical tumor removal (Simpson grade I and II). Location (parasagittal and falx 11, convexity 9, skull base 17) and histopathology (transitional WHO I° 12, meningothelial WHO I° 9, fibrous WHO I° 6, secreting WHO I° 4, atypical WHO II° 6) of tumors varied greatly. About one half (18/37) of patients had 2 or more associated medically treated diseases. Most frequent were hypertension, diabetes, coronary heart disease and obstructive pulmonary disease.
Results
After surgery 19 patients (51%) recovered completely and returned to normal daily life activities. 9 (24%) were independent with little support. 6 (16%) needed constant care. 3 (8%) patients died subsequently related to surgery. All three had suffered from obstructive pulmonary disease at the time of surgery. Two patients developed hemorrhagic infarctions. Other complications, namely CSF-fistulas (5), wound infection (1) and pneumonia (1) were transitory and resolved completely. Complications occurred in 32,4% (3 deaths, 1 wound infection, 5 CSF-fistulas, 2 hemorrhagic infarctions, 1 pneumonia). Outcome seemed to correlate with accompanying diseases, especially obstructive pulmonary disease.
Conclusions
Satisfactory outcome of meningioma surgery in geriatric patients can be achieved in up to 75%. The Complication rate is high. Because of the higher risk of surgery in this age group, thorough patient selection is crucial. Especially pre-existing obstructive pulmonary disease seems to complicate the postoperative course.