90歳以上超高齢者腹部手術症例の検討

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  • OUTCOMES OF ABDOMINAL SURGERY IN PATIENTS 90 YEARS AND OLDER

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The outcomes of abdominal surgery in 11 patientss 90 years and older were evaluated. Two patients with incarcerated femoral hernia, 2 with incarcerated obturator foramen hernia, and one with perforation of the jejunum underwent intestinal resection, one of whom with obturator foramen hernia had additional procedures for cholecysto-choledocholithiasis and ovarian cyst. Simple closure was performed in a patient with perforated duodenal ulcer. Two patients with large-bowel cancer and one with jejunual cancer underwent curative intestinal resection with lymph node dissection, whereas colostomy for palliation was performed in 2 large-bowel cancer patients. Of these, seven (64%) patients underwent emergency operation. A general anesthesia was performed in 5 (45%) patients. Major complication occurred in one (9%) patient and postoperative death within 30 days was encountered in 2 (18%). Preoperative underlying diseases and abnormal laboratory parameters had no correlation with postoperative morbidity. However, patients with ASA (American society of anestheologists physical status classification) class III showed shorter survival than class II patients.<br> In conclusion, it is suggested that such abdominal surgery as reported herein can be safely performed in patients even 90 years and older by selecting the method of anesthesia appropriate to individual cases and avoiding excessive surgical stress, and that long-term survival may be poorer for patients with higher ASA classification.

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