Modern medical science has lots of different ways to help us and treat our problems. This includes hundreds of different regularly-performed surgeries, each solving a different issue and each – with a different level of risk involved.
Those risks also vary a lot depending on a person’s overall health condition. That’s why medical professionals always try their best to assess the individual risks for each patient before surgery.
One of the key risk factors when it comes to most surgeries is one that’s unavoidable – age. The older we get, the more our bodies start accumulating general wear and tear. So, while some surgeries are relatively low- or medium-risk for younger people, they can become life-threatening for older patients.
It’s precisely those risks that a 2015 study tried to examine. Published in JAMA Surgery, the study detailed 277 different risk procedures for older adults and examined their outcomes.
The study used admission data for patients 65 years and older from multiple different hospitals. A total of 4 739 522 patients were examined and 10 procedures were identified to be especially risky.
1. Adrenal gland removal
Also called adrenalectomy, this procedure centers around the removal of one or both of our adrenal glands. These glands produce hormones necessary for our day-to-day bodily functions. However, when tumors start forming in them, an adrenalectomy is often unavoidable.
According to the Cleveland Clinic, recovering from an adrenal gland removal can require between 2 and 6 weeks of recovery time. The procedure is high-risk as it can lead to blood clots, infections, and high blood pressure.
2. Plaque buildup removal from carotid arteries
Called carotid endarterectomy, this surgery removes plaque buildup from inside the carotid artery on a person’s neck. A very high-risk procedure, carotid endarterectomy is sometimes necessary as said plaque can obstruct the blood flow to the brain.
This is a preventative procedure against strokes as it removes the very buildup that can cause them. However, it still runs the risk of causing a clot or a stroke if the buildup was already too much as the National Heart, Lung, and Blood Institute points out. Fortunately, the risks can be mitigated a bit by taking anti-clotting medicine before and after the surgery.
3. Arm blood vessel replacements
Arteries in our arms can get blocked or narrowed as well, leading to reduced blood flow in the arm. This procedure is called peripheral vascular bypass surgery and it does more than just clean your arteries. Here, your arm’s artery is replaced with an artery from another part of your body or with a whole new synthetic blood vessel. The main risk here, outlined by the Summit Medical Group is infection and death.
4. Abdominal vein resection or replacement
A similar procedure to the one above, abdominal vein replacements and resections are done to avoid health complications due to clogged or damaged abdominal veins. As John Hopkins Medicine points out, the procedure itself can also cause an infection, a pulmonary embolism, and excess bleeding.
5. Varicose vein removal
Another common vein removal surgery, this one is done to the veins in our legs when they stop functioning properly. A problem for many people today, this surgery is usually preceded by pain, blood clots, and bleeding. These can lead to many serious complications which is why doctors will usually recommend a varicose vein removal. The procedure is not without its risks too, however, as it can cause nerve damage, infections, and heavy bleeding.
6. High gastric bypass
This procedure is received for people with an urgent need for weight management. The high gastric bypass changes how your stomach and intestines handle food and how much they can take. As a result, patients start eating less and lose weight very quickly.
It is a high-risk procedure, which is why the patient must meet a myriad of criteria to qualify for it. The many possible complications from a high gastric bypass include stomach or intestine perforation during the procedure, malnutrition as a result of the lowered food intake, and dumping syndrome – a syndrome in which the food is directly “dumped” from the stomach into the small intestine without being digested.
Also known as rectal prolapse surgery, this procedure is done when the patient has trouble controlling their bowel movements (fecal incontinence), experiences stool leakage, or has obstructed bowel movements. Essentially, proctopexy puts the rectum back in place and removes the irregularities.
Its risks, according to the Mayo Clinic involve developing or worsening of constipation, damage to the nearby nerves and organs, or a narrowing of the anal opening.
8. Bile duct extraction
This extraction is typically done when a tumor is obstructing the flow of bile in the patient’s bile ducts. The procedure can lead to a series of complications, including jaundice, nausea, or high body temperature.
9. Urinary reconstruction technique
This is essentially a follow-up to a bladder removal. The latter is sometimes necessary due to the presence of a cancer, the general dysfunction of the bladder, or another reason. As the bladder is essential for urination, urinary reconstruction becomes necessary to enable the patient to urinate without a bladder.
The most common risk from this procedure is urine going back into the kidneys, as well as infections, kidney stones formation, and organ damage.
10. Ureter repair
The ureter is usually damaged due to physical injuries. This can necessitate a ureter repair. The possible complications of this surgery can include blood clots, chest pain, and troubles urinating.
What does this mean for you?
The purpose of the study wasn’t to dissuade older patients from undergoing these procedures, of course. High-risk or not, some procedures still have to be done. So, the study’s authors Margaret L. Schwarze, MD, Amber E. Barnato, MD, and Paul J. Rathouz, PhD still urge patients to always follow the advice of their medical consultant.
The study is simply meant to inform people of how risky each surgery is. At the very least, this information can guide younger adults about which health problems are especially important to avoid.