Bouhassira Jonathan, Bosc Romain, Greta Lipa, Hersant Barbara, Niddam Jeremy, Zehou Ouidad, Roudot-Thoraval Françoise, Wolkenstein Pierre, Meningaud Jean-Paul
Department of Plastic, Reconstructive and Aesthetic Surgery, Henri Mondor Hospital, Creteil, France; UPEC, University Paris East Creteil, Val de Marne, France.
Department of Plastic, Reconstructive and Aesthetic Surgery, Henri Mondor Hospital, Creteil, France; UPEC, University Paris East Creteil, Val de Marne, France.
J Geriatr Oncol. 2016 Jan;7(1):10-4. doi: 10.1016/j.jgo.2015.11.004. Epub 2016 Jan 4.
The increasing frequency of skin tumors and longer life expectancy of the general population are likely to increase the frequency of dermatological surgery among elderly patients. The purpose of this study is to assess the rate of postoperative complications related to dermatological surgery in elderly patients and highlight the factors associated with these complications.
We conducted a retrospective monocentric study of patients aged >75 years who presented at our multidisciplinary consultation specialized for skin tumors from January 2008 to December 2010. The clinical characteristics, demographic information, and cancer history of these patients were analyzed. Postoperative complications (dehiscence, infection, hematomas, and other sequelae) were identified to establish the postoperative complication rate and determine risk factors.
We included 241 patients. Basal cell carcinoma, squamous cell carcinoma, and melanoma accounted for 46%, 25%, and 28% of tumors, respectively. Skin carcinomas were mainly located on the face (93% of basal cell carcinomas and 72% of squamous cell carcinomas), and melanomas were mainly located on the limbs (50%). The average number of comorbidities was 3.0±1.5. The average postoperative complication rate was 20%. Multivariate analysis identified three independent risk factors: male gender (p<0.033), histological type (squamous cell carcinoma and melanoma) (p<0.008), and insufficient surgical resection (p<0.004).
This study highlighted a high rate of postoperative complications in this elderly population. Three significant postoperative risk factors were identified. They may be used to assess a patient's operational risk as well as geriatric assessment tools.
皮肤肿瘤发病率的上升以及普通人群预期寿命的延长，可能会增加老年患者皮肤科手术的频率。本研究的目的是评估老年患者皮肤科手术后并发症的发生率，并突出与这些并发症相关的因素。
我们对2008年1月至2010年12月在我们专门针对皮肤肿瘤的多学科会诊中就诊的75岁以上患者进行了一项回顾性单中心研究。分析了这些患者的临床特征、人口统计学信息和癌症病史。确定术后并发症（裂开、感染、血肿和其他后遗症）以确定术后并发症发生率并确定危险因素。
我们纳入了241例患者。基底细胞癌、鳞状细胞癌和黑色素瘤分别占肿瘤的46%、25%和28%。皮肤癌主要位于面部（基底细胞癌的93%和鳞状细胞癌的72%），黑色素瘤主要位于四肢（50%）。合并症的平均数量为3.0±1.5。术后平均并发症发生率为20%。多变量分析确定了三个独立的危险因素：男性（p<0.033）、组织学类型（鳞状细胞癌和黑色素瘤）（p<0.008）和手术切除不足（p<0.004）。
本研究突出了该老年人群术后并发症的高发生率。确定了三个重要的术后危险因素。它们可用于评估患者的手术风险以及老年评估工具。
