Journal of Advanced Surgical Research

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Perspective - Journal of Advanced Surgical Research (2025) Volume 9, Issue 4

Geriatric surgery: Comprehensive, proactive, patient-focused

Natalia Petrova*

Department of Geriatric Surgery, Moscow Gerontological Medical University, Moscow, Russia

*Corresponding Author:
Natalia Petrova
Department of Geriatric Surgery
Moscow Gerontological Medical University, Moscow, Russia.
E-mail: natalia.petrova@moscowgerimed.ru

Received : 04-Sep-2025, Manuscript No. aaasr-230; Editor assigned : 08-Sep-2025, PreQC No. aaasr-230(PQ); Reviewed : 26-Sep-2025, QC No aaasr-230; Revised : 07-Oct-2025, Manuscript No. aaasr-230(R); Published : 16-Oct-2025 , DOI : 10.35841/2591-7765-9.4.230

Citation: Petrova N. Geriatric surgery: Comprehensive, proactive, patient-focused. aaasr. 2025;09(04):230.

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Introduction

Surgical care for older adults presents a growing challenge and area of critical research, given the increasing demographic of elderly patients undergoing various procedures. This body of literature highlights crucial considerations ranging from preoperative assessment to postoperative management, emphasizing tailored approaches to improve patient safety and long-term outcomes. Understanding the unique physiological characteristics and increased vulnerabilities of older surgical patients is paramount. Recent studies provide valuable insights into specific areas requiring focused attention. This article comprehensively reviews current frailty assessment tools and their clinical utility in older surgical patients. It emphasizes how pre-operative frailty screening can predict postoperative complications and mortality, guiding personalized care plans and improving surgical outcomes for the elderly [1].

This narrative review explores the significant impact of postoperative delirium on older surgical patients, discussing its prevalence, risk factors, and the detrimental effects on long-term cognitive and functional outcomes. It highlights the importance of early identification and multi-component interventions [2].

This article focuses on the critical role of preoperative nutritional optimization for older adults undergoing major surgery. It emphasizes that identifying and addressing malnutrition preoperatively can significantly reduce postoperative complications, improve recovery, and enhance overall patient outcomes [3].

This systematic review and meta-analysis highlight the adverse impact of sarcopenia on surgical outcomes in older adults. It demonstrates that sarcopenic patients face increased risks of postoperative complications, longer hospital stays, and higher mortality rates, underscoring the need for routine sarcopenia screening [4].

This narrative review discusses current challenges in geriatric anesthesia, including physiological changes related to aging, polypharmacy, and increased susceptibility to postoperative complications like delirium. It advocates for tailored anesthetic approaches to optimize safety and outcomes in older surgical patients [5].

This narrative review explores the principles and benefits of shared decision-making in geriatric surgery. It emphasizes the importance of involving older patients and their families in surgical planning, considering their values, preferences, and goals of care to ensure patient-centered treatment [6].

This article provides current perspectives on postoperative cognitive dysfunction (POCD) in elderly patients, detailing its risk factors, diagnostic approaches, and potential mechanisms. It underscores the need for proactive strategies to prevent and manage this common and debilitating complication [7].

This systematic review and meta-analysis evaluates the efficacy of Enhanced Recovery After Surgery (ERAS) protocols in older adults. It concludes that ERAS pathways are safe and effective in this population, significantly reducing postoperative complications, length of hospital stay, and improving functional recovery [8].

This narrative review addresses the unique challenges encountered in oncological surgery for elderly patients, including age-related physiological decline, multimorbidity, and treatment tolerability. It emphasizes individualized risk stratification and multidisciplinary team approaches to optimize care and outcomes [9].

This systematic review and meta-analysis investigate the effectiveness of prehabilitation programs in older adults undergoing major surgery. It concludes that multimodal prehabilitation significantly improves functional capacity, reduces postoperative complications, and enhances recovery in this vulnerable population [10].

 

Conclusion

Surgical care for older adults presents unique challenges and requires specialized, patient-centered approaches. Key concerns include comprehensive preoperative assessments for conditions like frailty, malnutrition, and sarcopenia, which are critical predictors of postoperative complications, prolonged hospital stays, and mortality. Frailty screening and nutritional optimization significantly improve outcomes, while sarcopenia screening is crucial due to its adverse impact on recovery. Postoperatively, older patients are highly susceptible to cognitive issues such as delirium and postoperative cognitive dysfunction (POCD), both demanding early identification and proactive management to prevent long-term detrimental effects. Anesthetic care must be tailored to account for age-related physiological changes and polypharmacy, and specialized fields like oncological surgery require individualized risk stratification and multidisciplinary teams. To enhance recovery and minimize complications, modern geriatric surgery emphasizes proactive interventions. Multimodal prehabilitation programs effectively boost functional capacity and reduce complications. Enhanced Recovery After Surgery (ERAS) protocols are proven safe and effective, leading to shorter hospital stays and better functional recovery. Crucially, involving older patients and their families in shared decision-making ensures treatment plans align with their values and goals, promoting truly patient-centered care and optimizing overall surgical outcomes in this vulnerable population.

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