Kirk R M
Royal Free Hospital, London.
J R Soc Med. 1988 Jan;81(1):7-9. doi: 10.1177/014107688808100105.
In-hospital mortality was 9.6% in 3000 abdominal and abdominothoracic operations carried out by me or under my care. Intra-abdominal complications developing during the recovery period required reoperation in 141 patients. The decision to reoperate was a clinical one in 97.8%, although investigations were often helpful in localizing the site of the complicating lesion: the mortality in this group was 42.5%. Technical failure at the first operation could be indicated in 46%. Leaks and bleeding were most frequent and carried a high mortality. Patient selection and preparation, and selection of the simplest effective procedure, are not yet capable of being fully assessed in an individual patient.
在我主刀或由我负责的3000例腹部及胸腹联合手术中,院内死亡率为9.6%。恢复期出现的腹腔内并发症致使141例患者需要再次手术。97.8%的再次手术决定是基于临床判断做出的,尽管检查常常有助于确定并发症病变的位置:该组患者的死亡率为42.5%。首次手术存在技术失误的情况占46%。渗漏和出血最为常见,且死亡率很高。患者的选择与准备以及最简单有效手术方式的选择,在个体患者中仍无法得到全面评估。