80歳以上高齢者の消化器手術症例の検討

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  • Gastroenterological Surgery for Elderly Patients Over 80 Years Old.

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A series of 102 elderly patients over 80 years old undergoing gastroenterological surgery in our department in a recent 15-year period from January 1985 to December 1999 were subjected to a study surgical outcomes and problems. Underlying diseases including hypertension, previous myocardial infarction, previous cerebral infarction, arrhythmia, diabetes mellitus and bronchial asthma were recognized in 55 patients (53.9%). Postoperative complications inculuding delirium, pneumonia, heart failure and arrhythmia were recognized in 36 patients (35.3%). A comparison between 32 elderly patients with gastric cancer and 208 patients in their sixties showed no significant difference in underlying diseases, but significantly higher incidence of postoperative complications was noted in the elderly patients with gastric cancer. Some results were obtained in another comparison between 36 elderly patients with colon cancer and 107 patients in their sixties. Although postoperative complications occurred in the elderly patients in a high incidence, 93 (91.2%) out of 102 patients were able to leave the hospital without any decline of ADL. It is thought that even elderly patients who have some underlying disease can be discharged without any decline of ADL after gastroenterological surgery, if appropriate procedure is selected and strict postoperative management is perfomed.

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