CLINICAL STUDY ON GASTROINTESTINAL SURGERIES FOR PATIENTS OVER THE AGE OF 80-EVALUATION OF PRE AND POSTOPERATIVE CARE

Forty cases of gastrointestinal surgery in patients over the age of 80 who were treated at our hospital between April 1992 and March 1999 were studied in terms of changes in pre and postoperative activity of daily life (ADL) and the degree to which the patients were bedridden. Preoperative abnormali...

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Published inNihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 62; no. 1; pp. 1 - 7
Main Authors ENDO, Sachio, KOH, Shunhan, TAKAHASHI, Osamu, SHIMODA, Tsukasa
Format Journal Article
LanguageEnglish
Published Japan Surgical Association 2001
Subjects
ADL
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ISSN1345-2843
1882-5133
DOI10.3919/jjsa.62.1

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Abstract Forty cases of gastrointestinal surgery in patients over the age of 80 who were treated at our hospital between April 1992 and March 1999 were studied in terms of changes in pre and postoperative activity of daily life (ADL) and the degree to which the patients were bedridden. Preoperative abnormalities in laboratory data and underlying disorders were confirmed in 90% of the subjects. Except for cases of emergency operation and those of palliative surgery for malignancy, none of the cases undergoing elective surgery experienced severe complications and all cases were able to tolerate the surgeries. However, when changes in ADL were reviewed in 30 patients who had been discharged, some deterioration in movement and excretion were observed in six patients (20%). Two patients experienced a significant deterioration, from ‘independent’ to ‘bedridden’. Surgical intervention should be minimized in elderly patients, and the possibility of a postoperative deterioration in ADL should be considered in addition to the patient's ability to tolerate the operation. Systems offering postoperative support and care should also be established.
AbstractList Forty cases of gastrointestinal surgery in patients over the age of 80 who were treated at our hospital between April 1992 and March 1999 were studied in terms of changes in pre and postoperative activity of daily life (ADL) and the degree to which the patients were bedridden. Preoperative abnormalities in laboratory data and underlying disorders were confirmed in 90% of the subjects. Except for cases of emergency operation and those of palliative surgery for malignancy, none of the cases undergoing elective surgery experienced severe complications and all cases were able to tolerate the surgeries. However, when changes in ADL were reviewed in 30 patients who had been discharged, some deterioration in movement and excretion were observed in six patients (20%). Two patients experienced a significant deterioration, from ‘independent’ to ‘bedridden’. Surgical intervention should be minimized in elderly patients, and the possibility of a postoperative deterioration in ADL should be considered in addition to the patient's ability to tolerate the operation. Systems offering postoperative support and care should also be established.
Author SHIMODA, Tsukasa
ENDO, Sachio
TAKAHASHI, Osamu
KOH, Shunhan
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  fullname: SHIMODA, Tsukasa
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References 7) 川原田嘉文,岩崎 誠,岩田 真:高齢者手術における術前評価とその対策.消外 14: 29-36, 1991
9) 石神純也,山田一隆,朝沼 榎他:高齢者大腸癌の外科治療について.日消外会誌 27: 1961-1967, 1994
18) 愼島敏治,遠藤 健,喜島健雄他: 80歳以上の高齢者の消化器手術における術後合併症.日臨外医会誌 51: 239-243, 1990
1) 石山 賢,森岡恭彦,渡辺千之他:高齢者消化器手術の適応限界.手術 41: 37-42, 1987
10) 桜本邦男,岡島邦雄,山田真一他:満80歳以上高齢者胃癌手術例の検討.日臨外医会誌 50: 1477-1482, 1989
12) 長見晴彦,田村勝洋,中瀬 明:高齢者胃癌手術症例の臨床的検討-特に70歳手術症例と80歳手術症例の比較を中心として-.日臨外医会誌 52: 2559-2565, 1991
6) 永田松夫,落合武徳,鈴木孝雄他:教室における高齢者胃癌(80歳以上)の治療と問題点.日臨外医会誌 54: 1173-1179, 1993
16) 桜本邦男,岡島邦雄,富士原彰他:高齢者胃癌手術における侵襲範囲とリスクファクタ.日消外会誌 19: 2100-2103, 1986
2) 武川 悟,長濱 徴,冨木裕一他:超高齢者大腸癌切除症例の検討.日臨外医会誌 57: 2641-2645, 1996
3) 待木雄一,太田博俊,畦倉 薫他:高齢者大腸癌の臨床的検討.日消外会誌 24: 81-88, 1991
15) 森田隆幸,橘川 正,今 充他:高齢者大腸癌症例の検討.日消外会誌 20: 2431-2434, 1987
20) 東山孝一,梨本 篤,佐々木壽英他: 80歳以上の高齢者胃癌における外科治療上の問題点.日消外会誌 24: 771-778, 1991
13) 林 四郎,市川英幸:老人に対する手術適応の判断.治療 68: 479-485, 1986
8) 厚生省高齢者ケアサービス体制整備検討委員会:介護支援専門員標準テキスト.第2巻,補訂版,財団法人長寿社会開発センター,東京, 1998, p222-225
11) 内田信之,小板橋宏,長町幸雄:高齢者 (80歳以上)の胃癌,大腸癌の検討-とくに術後合併症を中心に-.日臨外医会誌 55: 1947-1952, 1994
5) 羽生 丕,鴻野雅司,谷 雅也他:高齢者胃癌の適応判断.日消外会誌 20: 2427-2430, 1987
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4) 大谷吉秀,戸倉康之,山藤和夫他:高齢者 (80歳以上)胃癌切除例の検討-遠隔成績からみた外科治療上の問題点-.日臨外医会誌 55: 547-554,1994
14) 山本篤志,河野博光,船越真人他:高齢者(80歳以上)胃癌症例の予後に関する検討-手術例と非手術例の比較検討-.日臨外会誌 59: 1984-1988, 1998
17) 藤井一郎,広瀬周平,高橋健治: 80歳以上の高齢者の消化器手術における術後合併症.日消外会誌 19: 729-733, 1986
References_xml – reference: 19) 福井 聖,竹山栄子: 80歳以上の開腹手術の心,肺合併症に対する硬膜外麻酔の影響.臨麻 14: 1023-1024, 1990
– reference: 7) 川原田嘉文,岩崎 誠,岩田 真:高齢者手術における術前評価とその対策.消外 14: 29-36, 1991
– reference: 15) 森田隆幸,橘川 正,今 充他:高齢者大腸癌症例の検討.日消外会誌 20: 2431-2434, 1987
– reference: 6) 永田松夫,落合武徳,鈴木孝雄他:教室における高齢者胃癌(80歳以上)の治療と問題点.日臨外医会誌 54: 1173-1179, 1993
– reference: 16) 桜本邦男,岡島邦雄,富士原彰他:高齢者胃癌手術における侵襲範囲とリスクファクタ.日消外会誌 19: 2100-2103, 1986
– reference: 11) 内田信之,小板橋宏,長町幸雄:高齢者 (80歳以上)の胃癌,大腸癌の検討-とくに術後合併症を中心に-.日臨外医会誌 55: 1947-1952, 1994
– reference: 14) 山本篤志,河野博光,船越真人他:高齢者(80歳以上)胃癌症例の予後に関する検討-手術例と非手術例の比較検討-.日臨外会誌 59: 1984-1988, 1998
– reference: 13) 林 四郎,市川英幸:老人に対する手術適応の判断.治療 68: 479-485, 1986
– reference: 20) 東山孝一,梨本 篤,佐々木壽英他: 80歳以上の高齢者胃癌における外科治療上の問題点.日消外会誌 24: 771-778, 1991
– reference: 8) 厚生省高齢者ケアサービス体制整備検討委員会:介護支援専門員標準テキスト.第2巻,補訂版,財団法人長寿社会開発センター,東京, 1998, p222-225
– reference: 1) 石山 賢,森岡恭彦,渡辺千之他:高齢者消化器手術の適応限界.手術 41: 37-42, 1987
– reference: 9) 石神純也,山田一隆,朝沼 榎他:高齢者大腸癌の外科治療について.日消外会誌 27: 1961-1967, 1994
– reference: 10) 桜本邦男,岡島邦雄,山田真一他:満80歳以上高齢者胃癌手術例の検討.日臨外医会誌 50: 1477-1482, 1989
– reference: 2) 武川 悟,長濱 徴,冨木裕一他:超高齢者大腸癌切除症例の検討.日臨外医会誌 57: 2641-2645, 1996
– reference: 5) 羽生 丕,鴻野雅司,谷 雅也他:高齢者胃癌の適応判断.日消外会誌 20: 2427-2430, 1987
– reference: 12) 長見晴彦,田村勝洋,中瀬 明:高齢者胃癌手術症例の臨床的検討-特に70歳手術症例と80歳手術症例の比較を中心として-.日臨外医会誌 52: 2559-2565, 1991
– reference: 18) 愼島敏治,遠藤 健,喜島健雄他: 80歳以上の高齢者の消化器手術における術後合併症.日臨外医会誌 51: 239-243, 1990
– reference: 3) 待木雄一,太田博俊,畦倉 薫他:高齢者大腸癌の臨床的検討.日消外会誌 24: 81-88, 1991
– reference: 17) 藤井一郎,広瀬周平,高橋健治: 80歳以上の高齢者の消化器手術における術後合併症.日消外会誌 19: 729-733, 1986
– reference: 4) 大谷吉秀,戸倉康之,山藤和夫他:高齢者 (80歳以上)胃癌切除例の検討-遠隔成績からみた外科治療上の問題点-.日臨外医会誌 55: 547-554,1994
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Title CLINICAL STUDY ON GASTROINTESTINAL SURGERIES FOR PATIENTS OVER THE AGE OF 80-EVALUATION OF PRE AND POSTOPERATIVE CARE
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