Considerations of the Pre- and Postoperative Complications in the GeriatricSurgery over 70 Years of Age
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Twenty-eight cases of the aged over 70 years had 31 operations at the Tokyo National Chest Hospital during last 5 years, and the complications of pre-, intra- and postoperation were studied. The series contains 17 operations of thoracic surgery including 11 pulmonary resections and 14 of abdominal surgery including 10 of upper abdomen, and among them 20 operations were for cancer.As the preoperative complications five severe cases were found in hepatic, renal, circulatory and/or respiratory lesions, and 15 cases of moderate or slight complications.No patient died during operation or anesthesia. In many cases of anesthesia duration of more than 2 hours, systolic and diastolic blood pressure and pulse rate were remarkably changeable, and in 75% of cases of more than 4 hours the systolic pressure changed more than 51mm Hg during anesthesia and one of them was complicated with postoperative acute renal failure due to circulatory shock during anesthesia.The operation death within 30 days were 5 cases. In 7 emergency cases 4 patients died while in 24 usual cases only one died. The mortality of emergency operations was very high. The causes of death were two renal failures, one hyponutrition with hypopotassemia, one rupture of esophageal varicocity and one haemorrhage of metastatic cerebral cancer.As the postoperative complications in survival cases, renal failure, hypopotassemia and hepatic failure were important as same as continuation or increasing of preoperative complications. While some literatures report the high rate of pulmonary complications after thoracic or upper abdominal surgery or in the cases of chronic lung disease, authors experienced only two cases of pulmonary complications. It seems to be very effective that for the purpose of prevention of pulmonary complication respiratory physiotherapeutic exercise and assistance were routinely carried out pre-and postoperatively in our hospital.As to other complications authors explained several considerations for preventive care.
- 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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