Frail Surgical Patient

Virginia Boccardi earned her MD in 2007 and completed her residency in Geriatrics in 2012, followed by a PhD in Metabolism and Aging in 2015, all at the University of Campania Luigi Vanvitelli, Italy. She is currently a Professor of Geriatric Medicine at the University of Perugia. Throughout her career, she spent nearly two years as a research fellow at the University of Medicine and Dentistry of New Jersey (USA), where she focused on cellular senescence and telomere biology. Her research spans multiple projects investigating the molecular and metabolic aspects of aging, with a particular focus on frailty, cognitive impairment, diabetes and the development of intervention strategies. Dr. Boccardi has published over 150 peer-reviewed articles in esteemed journals and contributed to several books and book chapters. She has been serving as an editorial board member of several internationally recognized Medical Journals.Luigi Marano, MD, PhD, is a Professor of Surgery at the Academy of Applied Medical and Social Sciences (AMiSNS) in Elblag, Poland, and a Visiting Professor at Dnipro State Medical University, Ukraine. He earned his MD in 2007, completed his residency in General Surgery in 2014, and obtained a PhD in Biotechnologies Applied to Medical and Surgical Sciences in 2016 from the University of Campania "Luigi Vanvitelli," Italy. From 2019 to 2022, he served as an Assistant Professor of Surgery at the University of Siena, before advancing to Associate Professor from 2022 to 2024. Prof. Marano has held leadership roles, including serving as the National Coordinator for the Young Section of the Italian Society of Surgical Oncology and as a Steering Committee Member of the European Young Surgeons and Alumni Club (EYSAC). He is currently a member of the Education and Training Committee (Upper GI) of the European Society of Surgical Oncology (ESSO) and contributes to the committees of the European Federation of the International Society for Digestive Surgery (EFISDS) and The RObotic Global Surgical Society (TROGSS). Prof. Marano's research focuses on robotic and minimally invasive surgical techniques, preoperative management, prehabilitation, and a multidisciplinary approach to gastrointestinal cancer. He aims to enhance surgical outcomes through individualized perioperative strategies. He has authored nearly 150 peer-reviewed articles and contributed to numerous books and chapters. Additionally, Prof. Marano serves on the editorial boards of several prominent medical journals, underscoring his contributions to surgical science and education.

• Preface.- PART I Background.- 1. The epidemiology of aging in surgical settings.- 2. Implications of population ageing for societies and governments.- 3. The impact of aging population on general surgical workforce needs.- 4. Aging trajectories and phenotypes.- 5. Understanding aging, frailty, and resilience.- 6. Surgical risk assessment: from chronological age to frailty status.- 7. Integrating geriatics principles into surgical care setting: a "Surgery for Frails" novel model.- 8. The role of a multidisciplinary team for shared strategies in gerosurgery.- PART II Pre-operative management.- 9. Multidimensional Prognostic Index in Surgery: a clinical perspective.- 10. Decision-making of surgical strategy in older and/or frail persons.- 11. The nurse: perioperative care and management.- 12. The nutritionist: malnutrition risk assessment and management.- 13. The importance of hydration and nutritional support.- 14. The geriatrician: from patient-centred perioperative care to geriatric syndromes management.- 15. Open surgery choice: what, why, when, and whom.- 16. Minimally invasive surgery choice: what, why, when, and whom.- 17. Geriatric Trauma.- PART III Post-operative management.- 18. The pain assessment and management.- 19. Post-operative delirium management.- 20. Fluid and Electrolyte Balance.- 21. Post-operative stress, metabolism, and catabolism.- 22. The nutritional support and recovery: the lesson learned form ERAS.- 23. The physiotherapist: The importance of early functional recovery.- 24. The early identification of post-demission setting.- 25. The role of intermediated care: what, why, when, and whom.- 26. The continuity of care: territory and general practitioner.- 27. Decision-Making at the End of Life.- 28. Living with frailty in geriatric patients: psychological stress and special needs to support emotional tension.- 29. Informed consent challenges in frail surgical patients.- 30. Bioethical Issues in Gerosurgery.