Schneider J, Benito R
Department of Gynecology, Universidad del Pais Vasco, Hospital de Cruces, Bilbao, Spain.
Surg Gynecol Obstet. 1988 Dec;167(6):497-500.
A series of 110 patients upon whom extensive gynecologic surgical procedures were performed between 1971 and 1986 are presented. All of the patients were 75 years of age or older at the time of operation. Abdominal surgical procedures were performed upon 49, and vaginal hysterectomies were performed upon the remaining 61. Among patients undergoing abdominal procedures, three deaths occurred; among those undergoing vaginal hysterectomies, one patient died (6.2 versus 1.6 per cent). Morbidity was high among both groups (43.5 per cent, abdominal group). Patients undergoing the vaginal procedure stayed in the hospital fewer days (9.6 versus 14.5 days). From this data, it is concluded that, if there is a clear indication for surgical procedure, it should be performed, regardless of the age of the patient, if there is no equal or superior medical alternative and if there is no absolute contraindication to anesthesia.
本文介绍了1971年至1986年间接受广泛妇科手术的110例患者。所有患者手术时年龄均在75岁及以上。49例行腹部手术,其余61例行阴道子宫切除术。腹部手术患者中有3例死亡;阴道子宫切除术患者中有1例死亡(分别为6.2%和1.6%)。两组的发病率都很高(腹部手术组为43.5%)。接受阴道手术的患者住院天数较少(分别为9.6天和14.5天)。根据这些数据得出结论:如果有明确的手术指征,在没有同等或更好的医疗替代方案且没有绝对麻醉禁忌证的情况下,无论患者年龄多大,都应进行手术。