Frascati, stomach tumor removed from an elderly woman without general anesthesia

ASL Rm 6: "Surgical intervention with cutting-edge technique"

ROME – Extraordinary surgery at theSan Sebastiano di Frascati hospitalwhere it was possible to avoid serious post-operative complications for Bice, an 85-year-old lady from Monte Compatri who was operated with spinal anesthesia rather than general anesthesia forthe removal of a large stomach tumor. There was no need for hospitalization in intensive care and no analgesic drugs were necessary during the post-operative stay.

The lady currently, less than a week after the operation, has had an early recovery and is in good health, she will soon be discharged to be reunited with her loved ones. Great satisfaction, regarding the anaesthesiological technique, was expressed by both the patient and the operating surgeon, Massimiliano Boccuzzi director of the General Surgery Unit and by his assistants Francesco Boccaccini and Angelo Torcasio assisted by the precious collaboration of the digestive endoscopy service of San Sebastiano (Fabrizio Travaglini).

The extraordinary commissioner of the ASL Roma 6 Francesco Marchitelli and the health director Vincenzo Carlo La Regina congratulated themselves on this extraordinary result: “This means saving lives – they said – we are faced with an operation that marks a fundamental step for the care of complex and advanced age patients who are increasingly forced to suffer serious post-operative complications or even to be unable to undergo to surgical interventions because they are excessively risky. People for people, this is another great testimony to the path of humanization of health that we intend to pursue together”. Technically it was a subtotal gastrectomy surgery for a large gastric neoplasm in an elderly woman with a complex clinical picture because she had already undergone surgery a few years ago for a colon neoplasm and underwent surgery twenty days ago for a post-traumatic femur fracture, again at San Sebastiano.

In consideration of the advanced age and the various comorbidities, in agreement with the patient, the team of the Uosd of Anesthesia and Resuscitation of San Sebastiano with the manager Benedetto Alfonsi, belonging to the Emergency Department directed by Carla Giancotti, decided to not perform the operation under general anesthesia, but rather under locoregional anesthesia, which was carried out by Benedetto Alfonsi in collaboration with Fabrizio Fattorini. The spinal anesthesia, necessary for the surgery, was associated with the bilateral Esp Block, an ultrasound-guided fascia block of the posterior chest wall. The fascia block was performed toensure postoperative analgesia without the need for opioids. Fascia blocks currently represent a further step forward in post-operative pain control. To improve operative comfort, the patient was lightly sedated during the operation. He is now well and the surgery was a success.

This testimony is also important from a scientific point of view in light of thecontinuous increase in patients over 80 with multiple comorbidities who increasingly turn to the Frascati Hospital, as it is located in an area demographically rich in retirement homes for the elderly and geriatric patients. “For several years – declares Massimiliano Boccuzzi, Uoc director of General Surgery at the Frascati hospital – there has been an increase in the number of elderly people undergoing major surgery which previously was a difficult obstacle to overcome for some types of patients and for years surgeons and anesthetists are engaged in the refinement of minimally invasive anesthetic and surgical techniques, which can lead to a significant reduction in anesthetic risks and surgical complications. In these technologies, the ASL Roma 6 is proving to be an important point of reference allowing operators to grow and perfect new techniques with low impact on post-operative complications”.