高齢者腹会陰式直腸切断術のPOSSUMスコアによる評価

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  • COMPARATIVE AUDIT OF ABDOMINOPERINEAL RESECTION IN THE ELDERLY USEING THE POSSUM SCOREING SYSTEMS

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We discuss the consequense of abdominoperineal resection (APR) in the elderly. In a recent 5-years period. 59 patients with rectal cance were operated on at the hospital, and 29 (42.9%) out of 59 patients underwent APR. One case was excluded because of a neurosurgical problem in the admission, and 28 cases were analysed by dividing them into two groups: 15 cases of 70 years and upward (elder group) and 13 cases under 70 years (younger group). Demographic data included gender, number of pre/postoperative complications, the Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) by Copeland, stage of rectal cancer, and postoperative hospital days.<br> The number of preoperative complications were 2.5 in elder group versus 1.0 in younger group, physiological score of POSSUM was 24.3/14.8, and total POSSUM score was 41.1/33.5. No difference was seen in operative procedures and stage of the disease. Number of cases associated with postoperative complication and postoperative hospital days were 3.5 and 1.5 cases and 66.1 and 51.7 days in elderly and younger groups, respectively. In addition, the elderly patients were divided into two subgroups by physiological score of POSSUM at 22 points, the high score subgroup had more postoperative complications and longer postoperative hospital stay.<br> So the older the patient is, the more intensive care is required in perioperative period.

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