Tiret L, Rotman N, Hatton F, Fagniez P L
INSERM, Unité 164, Villejuif.
Gastroenterol Clin Biol. 1988 Apr;12(4):354-60.
An epidemiological survey, carried out from 1978 to 1982 in 460 public and private institutions randomly selected from all parts of France, provided an assessment of the activity performed in digestive surgery. The sample included 37,967 patients, yielding an annual estimation of 700,000 patients operated on in the entire country. Digestive surgery was the first surgical domain (20 p. 100 of the entire surgical activity); 51.5 p. 100 of the patients were males and 53 p. 100 were under 35 yr of age. The annual incidence of these operations was 1.3 per 100 population. The first reason for operation was appendicitis (43 p. 100), followed by hernia (17.2 p. 100), gallbladder and biliary tract (10 p. 100), and anal diseases (7.7 p. 100). Digestive cancers led to 32,000 operations each year, with a majority of colonic cancers (40 p. 100). Except for appendectomy and operations on the gallbladder and biliary tract, most procedures were more frequent in males, especially operations on the stomach and esophagus. Incidences of appendectomy, cholecystectomy, inguinal hernia repair and operations for digestive cancers were assessed by sex and age. Incidence of appendectomy was 3 to 4 times greater than in other countries. Intraoperative and immediate postoperative (less than 24 h) mortality was higher for digestive operations (4.7 p. 1000) than for surgery as a whole (2 p. 1000). It increased with age and was higher in males.
1978年至1982年期间,在法国各地随机挑选的460家公立和私立机构开展了一项流行病学调查,对消化外科的手术活动进行了评估。样本包括37967名患者,据此估算出全国每年接受手术的患者有70万。消化外科是首要的外科领域(占整个外科手术活动的20%);51.5%的患者为男性,53%的患者年龄在35岁以下。这些手术的年发病率为每100人中有1.3例。手术的首要原因是阑尾炎(43%),其次是疝气(17.2%)、胆囊和胆道疾病(10%)以及肛门疾病(7.7%)。消化道癌症每年导致32000例手术,其中大多数是结肠癌(40%)。除了阑尾切除术以及胆囊和胆道手术外,大多数手术在男性中更为常见,尤其是胃和食管手术。按性别和年龄对阑尾切除术、胆囊切除术、腹股沟疝修补术以及消化道癌症手术的发病率进行了评估。阑尾切除术的发病率比其他国家高3至4倍。消化外科手术的术中及术后即刻(少于24小时)死亡率(4.7‰)高于整体外科手术(2‰)。死亡率随年龄增加,且男性更高。