Gainant A, Sautereau D, Minani M, Cubertafond P
Service de Chirurgie Générale A, CHRU Dupuytren, Limoges.
Ann Chir. 1992;46(10):923-7.
Between January 1981 and December 1990, 690 patients over the age of 80 years underwent gastrointestinal surgery. These operations were performed for diseases of the biliary tract in 248 cases (28%), colon or rectum in 238 cases (27%), stomach or duodenum in 130 cases (15%), small bowel in 32 cases (1.6%), oesophagus in 16 cases (1.8%), and for peritoneal carcinologic dissemination in 26 cases (3%). Emergency operation was performed in 43% of patients. Surgery was considered to be curative in 61% of patients. Overall postoperative mortality was 23%. The six following factors were associated with increased mortality: age over 85 years, ASA categories 3, 4, 5; surgery for malignant disease, peritonitis, palliative surgery, emergency surgery.
1981年1月至1990年12月期间,690例80岁以上患者接受了胃肠道手术。这些手术中,248例(28%)是针对胆道疾病,238例(27%)是针对结肠或直肠疾病,130例(15%)是针对胃或十二指肠疾病,32例(1.6%)是针对小肠疾病,16例(1.8%)是针对食管疾病,26例(3%)是针对腹膜癌性播散。43%的患者接受了急诊手术。61%的患者手术被认为是根治性的。总体术后死亡率为23%。以下六个因素与死亡率增加相关:年龄超过85岁、美国麻醉医师协会(ASA)分级为3、4、5级;恶性疾病手术、腹膜炎、姑息性手术、急诊手术。