Esser G, Wirtz G
Chirurgischen Klinik des Krankenhauses, Maria Hilf, Mönchengladbach.
Zentralbl Chir. 1987;112(17):1099-106.
The potential risk implied in prophylactic operations is just as high as that elective interventions. Indications must be subject to stringent deliminating criteria. Required are thorough elucidation and documentation as well as comprehensive substantiation. Operations of that kind may be performed even without elaborate advance planning, if indications are urgent. Simultaneous operations are accompanied by higher risk in cases of major surgery or if one of the interventions is septic. High risk factors were recordable from combined stomach and bile duct surgery, when performed simultaneously. Morbidity amounted to 13 per cent (pulmonary embolism and pneumonia) and lethality to 15 per cent. Simultaneous operations should be performed by an experienced surgeon who should be a fast worker.
预防性手术所隐含的潜在风险与选择性干预一样高。手术指征必须遵循严格的界定标准。需要进行全面的阐释、记录以及充分的论证。如果指征紧急，即便没有精心的预先规划，此类手术也可进行。在进行大型手术或其中一项干预为感染性手术时，同时进行多项手术会伴随更高的风险。在同时进行胃和胆管联合手术时，可记录到高风险因素。发病率为13%（肺栓塞和肺炎），死亡率为15%。同时进行的手术应由经验丰富且动作敏捷的外科医生实施。
