LEADING ARTICLE
Gastrointestinal surgery in old age: issues of equality and quality
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Introduction |
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Many recent developments in gastrointestinal surgery are of particular relevance to older people. They include new methods for the treatment or palliation of carcinoma, an increasing use of laparoscopic techniques (although the benefits of many of the approaches have yet to be proved in randomised controlled trials), and new treatments for non-malignant anal problems such as incontinence and prolapse.1-4 Meanwhile, the role of elective surgery in the field of peptic ulceration continues to decrease because of more effective medical treatments.1
The majority of research studies in the older surgical patient have
confined their attention to the surgical ward, typically correlating
the immediate preoperative risk factors with the immediate postoperative outcome.5 6
Although valuable insights can be gained from such studies, they are not considered further in the
present review. Rather, it is argued here that we need to take a wider
view of the referral and treatment process if our older
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