Clinical Analysis Of Gynecologic Surgical Treatment In 193 Cases Of Elderly Women

Objective:To investigate the clinical features and preoperative announcements of elderly gynecological surgery in order to improve the safety of the procedure.Methods: A retrospective study of 193 patients aged 60 years or older,treated by surgical procedure was performed between March 1,2009 and August 31,2010 in the first affiliated hospital of Dalian Medical University.To analyze clinical features of patients and the related factors about prognosis and preoperative management.We utilized statistical software to analyze the clinical data and tried to evaluate its meaning.Results:1.Age characteristic and onset characteristic of elderly women: The ages of 193 patients were from 60 to 86 years old,the mean age was 71 years. The most common disease was gynecological malignancies(37.3%).The second was pelvic organ prolapse (28.0%), the next one was benign ovarian tumor (17.6%).2.Preexisting medical illnesses: 126(65.3%)among 193 cases had one or more preexisting medical illnesses, the most common preexisting medical illness was cardiovascular disease, secondly was diabetes mellitus. Statistical results suggested that there were statistical differences between age and medical illnesses group(P<0.05).3.Complications: complications occurred in 67 patients (34.7%),while major surgical morbidity occurred in 2 cases, 1 case abandoned therapy and died after operation. Poor wound healing,urinary retention and anemia were common complications. Those who get complications had a longer hospital stay, compared the cases without complications, there were statistical significances (P<0.001).The former needed more operative time compared with the latter , a significant difference was found(P<0.001).Different age group and whether had preexisting medical illnesses was irrelevant with surgical morbidity, no significant significance(P>0.05).4.The influence of scope and way of operations on prognosis :radical operations had a higher surgical morbidity(P<0.05)and more hospital stay(P<0.001)than conservative operations. Vaginal group had a lower surgical morbidity and less hospital stay than abdominal group, a significant difference was found (P<0.05 .P<0.001)。Conclusion:1.The most common disease in 193 cases was malignancies,the second was pelvic organ prolapse. Endometrial carcinoma was the most common disease in gynecologic malignancies.2.Preexisting medical illnesses were common in elderly women. morbidity.Age alone was no longer a contraindication to surgery.3.Surgery range should be individualized according to disease and the physical condition. For elderly women, we should try to take select operation, choose conservative surgery, and operation time should be shortened as far as possible. We advocated minimally invasive surgery.4.Preexisting medical illnesses should be treatment.Perioperative complications should be prevented early and discovered timely and treated fully.