高血圧症と手術について
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概要
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1) During the period from January 1, 1958 through August 31, 1963, 508 patients received gastrectomy in our hospital including 184 malignant neoplasms such as gastric carcinoma and sarcoma, and 322 benign diseases such as peptic ulcer, gastric polyp, gastritis and so forth.2) Postgastrectomy complications occurred in 87 (17.1%) out of the total cases presented here, and these included heart failure, pneumonia, bronchitis, suture insufficiency, passage disturbance at the site of a hastomosis, opening of operative wound and others. The patients with malignant neoplasm developed the complications more frequently than those with benign disorder. Regardless of nature of the original diseases, the aged people were more frequently affected by the complications and showed more unfavorable prognosis for recovery from the complications.3) Mortality rate after gastrectomy was 5.3 percent for the total of 508 cases while that was 26.4 percent for 87 cases with postgastrectomy complications. The aged people showed the mortality rate to be 57.1 per cent for 14 cases having complications.4) Depennding upon the extent of stomach resected, the occurrence rate of the complications were varied, that is, it became higher and higher in the order of partial, subtotal and total gastrectomy. Seventeen out of 34 cases were succumed to the complications after total gastrectomy.Gastrectomy combined with additional operations such as splenectomy, colectomy, cholecystectomy and others were followed by the complications more frequently than gastrectomy alone.5) Of the preoperative complications, circulatory and hepatic disorders detected by ECG and liver function tests constituted the precipitating factors to increase the mortality rate after the post operative complications had developed.6) The patients with abnormal findings in ECG taken before operation were more liable to contract the post operative complications involved in circulatory and respirotory organs than those without the findings. Eight out of 11 cases which had coronary insufficiency in ECG passed away after operation.7) Eleven (2.1%) out of the total cases developed peritonitis secondary to suture insufficiency, 7 of which died of this complication. Passage disturbance at the site of an astomosis occurred in 8 cases (1.5% )which required further surgical intervention for the correction.
- 一般社団法人 国立医療学会の論文
一般社団法人 国立医療学会 | 論文
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