Mains Lindsay M, Magnus Manya, Finan Michael
Department of Obstetrics and Gynecology, Ochsner Clinic Foundation, 1514 Jefferson Highway, New Orleans, LA 70121, USA.
J Reprod Med. 2007 Aug;52(8):677-84.
To report perioperative morbidity and mortality rates in elderly women who underwent major gynecologic surgery.
The charts of 110 women between 80 and 91 years of age who underwent major gynecologic surgery between July 1995 and May 2003 were retrospectively reviewed.
The mean age was 83.1 years. Forty-nine procedures (44.1%) were performed for cancer, 32 (28.8%) for a mass and 23 (20.7%) for pelvic organ prolapse or urinary incontinence. Sixty-nine (62.7%) procedures were performed abdominally, 36 (32.4%) vaginally and 5 (4.5%) laparoscopically. Fifty (44.6%) patients experienced a postoperative complication, and 9 (8.1%) experienced a major one. Major complications included serious morbidity, in 5 (4.5%) patients, and mortality, in 4 (3.6%). Advanced age (> 85 years) was not associated with any of the outcomes of interest, while prior surgical history was significantly associated with a decreased hospital stay (p < 0.001). Increased hospital stay was associated with a moderate or severe medical history (p < 0.05) and laparotomy/laparoscopy vs. vaginal surgery (p < 0.01).
Postoperative complications occurred frequently among women > 80 years of age who underwent gynecologic surgery. The increased perioperative morbidity in the elderly should be considered when performing surgery on women in that age group.
报告接受大型妇科手术的老年女性围手术期的发病率和死亡率。
回顾性分析1995年7月至2003年5月期间110例年龄在80至91岁之间接受大型妇科手术的女性病历。
平均年龄为83.1岁。49例手术（44.1%）因癌症进行，32例（28.8%）因肿物进行，23例（20.7%）因盆腔器官脱垂或尿失禁进行。69例手术（62.7%）经腹部进行，36例（32.4%）经阴道进行，5例（4.5%）经腹腔镜进行。50例（44.6%）患者出现术后并发症，9例（8.1%）出现严重并发症。严重并发症包括5例（4.5%）患者出现严重发病情况，4例（3.6%）患者死亡。高龄（>85岁）与任何感兴趣的结局均无关联，而既往手术史与住院时间缩短显著相关（p<0.001）。住院时间延长与中度或重度病史（p<0.05）以及开腹手术/腹腔镜手术与阴道手术相比有关（p<0.01）。
80岁以上接受妇科手术的女性术后并发症频繁发生。对该年龄组女性进行手术时应考虑到老年人围手术期发病率增加的情况。
