Jalůvka V
Geburtshilfe Frauenheilkd. 1977 Apr;37(4):317-21.
In 17 gynaecological departments of West-Berlin hospitals, 2940 laparotomies were done between 1960 and 1969 in women of at least 60 years of age, of which 331 (10,9%) were exploratory. Of these the postoperative mortality was 39,2% (130 cases). The fatal cases could be divided into 120 women suffering from inoperable malignant tumors, 7 from sigmoid diverticulitis and 3 from chromical gynaecological inflammatory tumors. The frequency of such critical exploratory laparotomies could be lowered partly by intensifying cancer routine check-up by specialists by more complex diagnostic measures before the operations and by fewer adhesiotomies in cases of chronical inflammatory complaints. Most important, however, seems to be the well indicated application of laparoscopy under conditions that allow consecutive laparotomy if necessary. It is thought that to an experienced surgeon the diagnostic value of laparoscopy is almost equal to that of laparotomy. It therefore can be considered a true alternative.
1960年至1969年间，西柏林医院的17个妇科科室为至少60岁的女性进行了2940例剖腹手术，其中331例（10.9%）为探查性手术。这些探查性手术中，术后死亡率为39.2%（130例）。死亡病例可分为120例患有无法手术的恶性肿瘤的女性、7例患有乙状结肠憩室炎的女性和3例患有慢性妇科炎性肿瘤的女性。通过加强专科医生的癌症常规检查、在手术前采用更复杂的诊断措施以及减少慢性炎症患者的粘连松解术，这种危急探查性剖腹手术的频率可以部分降低。然而，最重要的似乎是在必要时允许连续剖腹手术的条件下合理应用腹腔镜检查。据认为，对于经验丰富的外科医生来说，腹腔镜检查的诊断价值几乎与剖腹手术相当。因此，它可被视为一种真正的替代方法。
