Kakinuma Kaoru, Kakinuma Toshiyuki, Kaneko Ayaka, Takeshima Nobuhiro, Yanagida Kaoru, Ohwada Michitaka
Graduate School of Medicine, International University of Health and Welfare, Narita-City, Chiba, Japan.
Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Nasushiobara-City, Tochigi, Japan.
Gynecol Minim Invasive Ther. 2024 Sep 7;13(4):215-220. doi: 10.4103/gmit.gmit_77_23. eCollection 2024 Oct-Dec.
We performed preoperative evaluations of giant ovarian tumors in older adult patients using the comprehensive geriatric assessment (CGA) and estimation of physiologic ability and surgical stress (E-PASS) scoring systems. We report a case in which the Aron Alpha method was performed, and perioperative management was performed using enhanced recovery after surgery (ERAS).
We performed preoperative evaluations using the E-PASS scoring system and CGA on older adult patients with giant ovarian tumors, followed by the minimally invasive Aron Alpha method and perioperative management using ERAS.
The mean patient age was 75.8 ± 8.8 years; comorbidities included hypertension in three patients, hyperlipidemia in two, angina pectoris in one, cholecystitis in one, and lower extremity varicose veins in one. The mean tumor size was 21.0 ± 5.4 cm. The E-PASS scoring system showed a preoperative risk score of 0.7 ± 0.4, a surgical stress score of 0, and a comprehensive risk score of 0.3 ± 0.3. CGA showed that two patients had problems with activities of daily living and cognitive function. The mean duration of surgery was 89.0 ± 16.6 min, and the mean blood loss was 56.0 ± 65.4 mL. No surgery-associated complications were observed. No patients had prolonged hospitalization or a decline in activities of daily living.
We showed the usefulness of performing detailed preoperative evaluations using CGA and the E-PASS system, followed by the minimally invasive Aron Alpha surgical method and perioperative management using ERAS in improving surgical outcomes in older adult patients with giant ovarian tumors.
我们使用综合老年评估（CGA）和生理能力与手术应激评估（E-PASS）评分系统对老年成年患者的巨大卵巢肿瘤进行术前评估。我们报告了一例采用阿隆阿尔法方法并使用术后加速康复（ERAS）进行围手术期管理的病例。
我们使用E-PASS评分系统和CGA对患有巨大卵巢肿瘤的老年成年患者进行术前评估，随后采用微创阿隆阿尔法方法并使用ERAS进行围手术期管理。
患者平均年龄为75.8±8.8岁；合并症包括3例高血压、2例高脂血症、1例心绞痛、1例胆囊炎和1例下肢静脉曲张。肿瘤平均大小为21.0±5.4厘米。E-PASS评分系统显示术前风险评分为0.7±0.4，手术应激评分为0，综合风险评分为0.3±0.3。CGA显示2例患者存在日常生活活动和认知功能问题。手术平均持续时间为89.0±16.6分钟，平均失血量为56.0±65.4毫升。未观察到与手术相关的并发症。没有患者住院时间延长或日常生活活动能力下降。
我们证明了使用CGA和E-PASS系统进行详细的术前评估，随后采用微创阿隆阿尔法手术方法并使用ERAS进行围手术期管理，对于改善老年成年巨大卵巢肿瘤患者的手术结局是有用的。
