Transactions from the 68th Annual Meeting of the South Atlantic Association of Obstetricians and GynecologistOutcomes of octogenarians and nonagenarians in elective major gynecologic surgery
Section snippets
Material and methods
This was a retrospective case control study of 120 patients over the age of 79 (group 1) who underwent major gynecologic procedures between January 1, 1995, and December 31, 2003 in a single tertiary care regional hospital. These patients are compared to a younger cohort (ages 50-79) of 1497 females undergoing similar procedures during the same time period (group 2). Approval for this study was obtained through the Medical Research Advisory Committee at Memorial Health University Medical
Results
One hundred twenty patients over the age of 79 (group 1) were compared to a younger cohort of 1,497 patients (group 2). The mean ages of the 2 groups were 83.34 (range 80-94) and 61.92 (range 50-79), respectively. There were 51 abdominal hysterectomies, 22 vulvar surgeries, 19 laparotomies, 14 vaginal hysterectomies, and 14 procedures for incontinence and pelvic floor prolapse in group 1 (Table I). Seven simple partial, 11 simple complete, 1 radical partial, and 3 radical complete vulvectomies
Comment
Our study is one of the larger case series of elderly patients undergoing major surgery, and is the first in the gynecologic literature to include a younger control group examining both benign and malignant cases to date. The size of retrospective case series published has ranged between 54 and 267 elderly women, none of which were compared to a younger cohort of patients.10, 11, 12, 13, 14, 15, 16, 17 Giannice et al compared 36 women undergoing surgery with pelvic lymphadenectomy to 72 women
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Cited by (26)
Complications of disease and therapy
2023, DiSaia and Creasman Clinical Gynecologic OncologyIntra-, peri- and postoperative complications in pelvic organ prolapse surgery in geriatric women
2018, European Journal of Obstetrics and Gynecology and Reproductive BiologyCitation Excerpt :The majority of non-severe complications were urinary tract infections. This corresponds to other studies in which urinary tract infections were observed in up to 15.8%–35.6% of gynecological surgeries [15,18]. There was one woman who suffered from prolonged pain after surgery.
Complications of disease and therapy
2018, Clinical Gynecologic OncologyHysterectomy for benign disease: Clinical practice guidelines from the French College of Obstetrics and Gynecology
2016, European Journal of Obstetrics and Gynecology and Reproductive BiologyCitation Excerpt :Advanced age is not a risk factor for bowel problems after hysterectomy (LE4) [54]. The prevalence of gastrointestinal injury does not seem to correlate with surgical experience (LE3) [55,56]. The prevalence of postoperative reflex ileus is 0.1% to 1.2% in the case of hysterectomy for benign disease [38,57–59].
Urinary, infectious and digestive adverse events related to benign hysterectomy and the associated surgery on the Fallopian tube: Guidelines
2015, Journal de Gynecologie Obstetrique et Biologie de la ReproductionUnderstanding and managing medication in elderly people
2013, Best Practice and Research: Clinical Obstetrics and GynaecologyCitation Excerpt :Seek haematology advice for people with impaired clotting, low platelet counts or who are unable to stop anti-platelet agents before surgery. Comorbidities, including diabetes mellitus, ischaemic heart disease, heart failure, hypertension and COPD are common in elderly people admitted for gynaecological procedures [89]. Patients included in the 2010 National Confidential Enquiry into Patient Outcome and Death (NCEPOD) in the UK commonly had these comorbidities [90].
William Hoskins, MD, is a Georgia Cancer Scholar and is supported in part by the Georgia Cancer Coalition
Presented at the Sixty-Eighth Annual Meeting of the South Atlantic Association of Obstetricians and Gynecologists, Orlando, FL, January 29-February 1, 2006.