[Progress and change in geriatric gynecological surgery (author's transl)]

Two periods of geriatric gynecological surgery (1947-1959 and 1960-1972) at the University Women's Hospital in Hamburg-Eppendorf were compared in regard to the age of the patient, surgical indications, surgical procedure, anesthetic technique, preoperative and postoperative morbidity, length of hospitalization and mortality rate. During a period of 26 years, 1514 women over the age of 60 were treated surgically. During the first period, 489 women were treated, and in the second period, 1,025. This 109.6% increase has been confirmed statistically. The increase in geriatric surgical cases stems basically from the increase in the number of surgical patients over the age of 70. The increase in breast carcinoma during the second period (from 43 to 348 operations) is most conspicuous. This is an increase of 809.3%. On the basis of this disproportionately large increase in breast surgery, more women were treated surgically in the University Women's Hospital in Hamburg-Eppendorf for breast carcinoma during the second period, than for carcinoma of the reproductive organs. Vulva carcinoma and craurosis vulvae were also more frequently considered to be an indication for surgical treatment. The total number of women who were surgically treated for prolapsed uterus and vagina remained more or less constant. In the analyzing the surgical records, it should be emphasized that, in the second observation period, two-thirds of these cases were treated by performing a vaginal hysterectomy with anterior and posterior vaginoplasty. For older patients, palliative surgical measures for prolapsed uterus and vagina were abandoned in favor of more definitive methods. The postoperative morbidity and mortality rate remained more or less constant for both periods. The postoperative period of hospitalization was slightly longer while the preoperative period was slightly shorter. The statistically confirmed increase in geriatric surgery during the last 13 years at the University Women's Hospital in Hamburg-Eppendorf clearly shows how important geriatric surgery has become. The immediate consequences are an increased workload for physicians, nursing staff and physical therapists.