Eight months later, a 95-year-old male patient, surnamed Wen, paid a return visit to Department of General Surgery of the First Affiliated Hospital of Xi’an Jiaotong University (XJTU). Physical examination showed that all indexes were normal and no sign of tumor recurrence was detected. Up to now, he is the oldest gastrointestinal cancer patient undergoing Da Vinci robot-assisted surgery in China.
Eight months ago,the elderly patient was diagnosed with gastrictumor complicated with bleeding due to nausea and hematemesis in a local hospital outside Shaanxi province. After emergency rescue, although the patient was temporarily out of danger, he had to undergo surgery for further recovery. Multiple hospitals advised him not to undergo surgery considering the senior age of 95 years and demanding surgery. Finally, his family sought Professor She Junjun from Department of General Surgery of our hospital for medical assistance.
After comprehensive examination and full evaluation, Professor SheJunjun proposed that surgery is the fundamental therapeutic solution. However, we should make full mental and technical preparation to guarantee intraoperative and postoperative risks are controllable, aiming to lift the upper age limit for complicated gastrointestinal surgery. Under the guidance of Sun Xuejun, Director of Department of General Surgery, multidisciplinary cooperation, full preparation of perioperative treatment, surgical regimen, anesthesia and emergency plan were explicitly delivered. Director Wang Qiang and Deputy Director Shen Xin from Department of Anesthesiology and Perioperative Medicine intimately monitored the anesthesia procedures. Chief Head Nurse Qiao Li’na from Department of General Surgery led the nursing team to deliver meticulous nursing care. Professor She Junjun, Deputy Chief Physician Wang Guanghui and PhD Shi Feiyu successfully completed Da Vinci robot-assisted radical total gastrectomyfor 3 h. The elderly patient was discharged after postoperative recovery.
According to our knowledge, he is the oldest patient undergoing Da Vinci robot-assisted gastrointestinal tumor surgery in China. Smooth operation and favorable recovery demonstrate that the upper age limit for gastrointestinal surgery can be lifted. Professor She Junjun highlighted that elderly patients with gastrointestinal cancer have weak body and organ function reserve, constantly complicated with basic diseases, characterized with low tolerance to surgery, frequent postoperative complications, high surgical risk and slow recovery. The diagnosis and treatment of elderly patients should be delivered with cautions, which also puts forward higher challenges and requirements for clinicians.
