Desrosiers J, Vaillancourt R, Heppell J, Latour J, Bourbeau D, Rheault M
Union Med Can. 1989 Mar-Apr;118(2):75-9.
The aim of our study is to analyze the clinical features and outcome of digestive surgery in the aged. From Jan. 1979 to Dec. 1981, 1,389 operations under general anesthesia were performed on patients 75 years old and more. From this group, 163 patients (111 females and 52 males, mean age: 79 +/- 0.7 years) underwent surgery of the alimentary tract. The procedures were divided in: colorectal (48%), biliary (32%), gastric (10%), small bowel (6%), esophagus (1%) and others (3%). An operation for cancer was performed in 63 patients: palliative (69%), curative (31%). The mean length of hospital stay is 23 days (pre-op 7 days, post-op 16 days). Only 16% of the patients needed intensive care. Postoperative complications occurred in 43 patients (26%); cardiovascular (47%), psychiatric (26%), pulmonary (23%) and others (4%). The overall mortality rate is 10%: 6% for elective cases and 24% for urgent cases (49 patients). The mortality is related to: sepsis and peritonitis (53%), cardiopulmonary disease (23%), hemorrhage (12%), cachexia (12%). At discharge, 62% of the patients returned home directly, 18% to convalescent homes, 10% to unknown places and 10% in nursing homes. Our data supports the benefit of surgery in the aged.
我们研究的目的是分析老年患者消化外科手术的临床特征及预后。1979年1月至1981年12月，对75岁及以上患者实施了1389例全身麻醉下的手术。在这组患者中，163例（111例女性，52例男性，平均年龄：79±0.7岁）接受了消化道手术。手术类型分为：结直肠手术（48%）、胆道手术（32%）、胃部手术（10%）、小肠手术（6%）、食管手术（1%）及其他手术（3%）。63例患者接受了癌症手术：姑息性手术（69%），根治性手术（31%）。平均住院时间为23天（术前7天，术后16天）。仅16%的患者需要重症监护。43例患者（26%）发生了术后并发症；心血管并发症（47%）、精神并发症（26%）、肺部并发症（23%）及其他并发症（4%）。总死亡率为10%：择期手术病例为6%，急诊手术病例为24%（49例）。死亡原因包括：脓毒症和腹膜炎（53%）、心肺疾病（23%）、出血（12%）、恶病质（12%）。出院时，62%的患者直接回家，18%的患者前往疗养院，10%的患者去向不明，10%的患者入住养老院。我们的数据支持老年患者手术的益处。
