Why Is the “After Surgery” Phase More Important for Older Patients?

[Financial News] For older patients, surgery does not end with “opening up the abdomen.” As more patients have conditions such as high blood pressure, diabetes and heart disease, coordinated care from multiple departments—from preoperative assessment through postoperative recovery—is becoming increasingly important.
South Korea is rapidly becoming an aging society. As people get older, they are more likely to have one or more chronic conditions, such as high blood pressure, diabetes and dyslipidemia, and a considerable number also have cardiovascular, kidney or respiratory diseases.
These changes are also changing the profile of patients undergoing surgery. Whereas surgery was once performed to treat a particular condition, it has now become common for patients with multiple chronic conditions to undergo surgery. In particular, when an older patient needs emergency or abdominal surgery, successfully completing the operation alone does not mean treatment is over.
Lee Sang-myeong, head of clinical services (surgery) at Incheon Sejong Hospital, said, “In an aging society, what older patients who need surgery truly need is not simply the ‘surgery’ itself. It is also important to accurately assess the patient’s overall condition before surgery, respond to risks that may arise during the operation, and manage the patient afterward to prevent existing conditions from worsening.”

Older patients may also need surgery for conditions such as acute cholecystitis, appendicitis, bowel obstruction or peritonitis. For a young patient without underlying conditions, the focus can be on the operation itself, but older patients are different. They may have high blood pressure or diabetes, and may have received treatment for a heart attack or angina in the past. They may also have arrhythmia, heart failure or reduced kidney function.
For these patients, doctors need to consider together how to assess their cardiovascular condition before surgery, how to adjust their medications, whether they face any risks from anesthesia, and whether existing conditions such as heart or kidney disease could worsen after surgery.
The director emphasized, “Surgery for older patients is not performed by a surgeon alone. It is important to provide comprehensive care for the patient through close coordination with relevant specialties, alongside surgical treatment.”
Anesthesiology and pain medicine is one key specialty. Anesthesia teams do more than administer anesthesia just before surgery. They assess the risks associated with surgery and anesthesia by taking into account the patient’s underlying conditions, medications, cardiopulmonary function and test results. For a patient with cardiovascular disease, they check the patient’s heart before surgery and, if needed, coordinate with relevant specialties to plan the operation.
During surgery, the team continuously monitors vital signs such as blood pressure, heart rate and oxygen saturation and responds to any changes. After surgery, they continue to support recovery and manage pain according to the patient’s condition. In this way, anesthesia care before, during and after surgery is one continuous course of treatment.

In this respect, the infrastructure of hospitals with expertise in treating heart disease can be an advantage for older patients with chronic conditions who need surgery.
Incheon Sejong Hospital is part of Hyeweon Medical Foundation, which operates Bucheon Sejong Hospital, a specialized cardiac hospital, and has a care system for patients with cardiovascular disease. When patients with cardiovascular disease undergo surgery, teams from surgery, anesthesiology and pain medicine, and heart-related specialties work together. Depending on the patient’s needs, specialists in endocrinology and metabolism, nephrology and pulmonology are also involved in their care.
The director explained, “What matters is not having one particular department solve every problem, but having multiple departments work together to manage the patient’s overall condition, with surgery at the center. For older patients, the period ‘after surgery’ may sometimes be more important.”
Even after surgery, older patients with chronic conditions need ongoing monitoring for pain and infection, changes in blood pressure and blood sugar, and the status of existing conditions such as heart or kidney disease. That is why preoperative assessment, anesthesia and surgery, postoperative recovery, and management of underlying conditions need to be part of one continuous course of treatment.
The director said, “Surgery in an aging society does not end with deciding ‘what operation to perform.’ It is a ‘comprehensive art of treatment’ that takes into account who will administer anesthesia, how the patient’s risks will be assessed before surgery, how changes during surgery will be addressed, and which specialties will support the patient afterward.” 




[email protected] Jung Myung-jin, medical correspondent Reporter