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We thank Konstantopoulos et al for their interest in our paper and congratulate them for having conducted such a large study. It should be noted, however, that we did not actually conclude that older age was not associated with an increased risk of intraoperative complications, rather we stated that our data suggest that age alone may not be a major risk factor for any complication. Clearly, absence of statistical evidence can never be equated to proof of no difference and we were careful to highlight that our numbers were small (9 patients older than 96, 111 greater than 88 years).
If we attempt to summarise data from our study, the Southampton Study and that by Berler to examine whether or not age greater than 88 is a risk factor for intraoperative complications using meta‐analysis techniques, we find that there is significant inconsistency between the studies (test for heterogeneity Χ2=7.54, p=0.02, I2 =73.5%). It seems likely therefore that the different findings from our work and that of Southampton are not simply a reflection of varying study sizes but arise from other differences between the studies: for example the populations being operated on, or perhaps the techniques employed.
We would therefore agree with Konstantopoulos et al that further research into this interesting subject is needed.