80 歳以上の高齢者における大腸穿孔手術の検討. (Japanese)

Colorectal Perforation Surgery in Elderly Patients Aged 80 Years or Older. (English)

Objective: We investigated the characteristics of surgical cases of colorectal perforation in elderly patients aged 80 years or older. Subjects: Patients who had undergone colorectal perforation surgery from 2015 to 2023 were divided into two groups: elderly patients aged 80 years or older (EP) and non-elderly patients aged 79 years or younger (NEP). Results: There were 20 patients in the EP group and 51 patients in the NEP group, and 9 deaths were noted (13%). Comparing the two groups, the EP group had a higher proportion of women (65% vs. 20%, p = 0.007), ASA-PS3 or higher (85% vs. 45%, p = 0.003), and coexisting multimorbidity (75% vs. 47%, p = 0.038). Meanwhile, no significant differences were noted between the two groups in terms of the incidence of complications of Clavien-Dindo classification II or higher (55% vs. 55%, p = 1.000) or 30-day postoperative mortality (14% vs. 4%, p = 0.145). Discussion: Although the mortality of patients undergoing colorectal perforation remained high, the results of this study were acceptable, demonstrating the possibility that even elderly patients aged 80 years or older could be saved. [ABSTRACT FROM AUTHOR]

【目的】80 歳以上の高齢者における大腸穿孔に対する手術症例の特徴について検討を行った. 【対象】 2015～2023 年までの大腸穿孔症例を対象とし 80 歳以上の高齢者 (EP) 群と 79 歳以下の非高齢者 (NEP) 群の 2 群に分け比較した. 【結果】EP 群 20 例, NEP 群 51 例. 死亡例は 9 例 (13％). 2 群間比較では EP 群で女性 (65％ vs 20％, p＝0.007), ASA-PS3 以上 (85％ vs 45％, p＝0.003), 多疾患併存 (75％ vs 47％, p＝0.038) の割合が多かった. 一方 Clavien-Dindo 分類Ⅱ以上の合併症の発生頻度 (55％ vs 55％, p＝1.000), 術後 30 日死亡率 (14％ vs 4 ％, p＝0.145) に関しては両群間で有意差はなかった. 【考察】 依然として致死率の高い大腸穿孔症例であるが 80 歳以上の高齢者でも救命が可能であり許容できる結果 であった. [ABSTRACT FROM AUTHOR]

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