[Exploratory laparotomies in geriatric-gynaecological patients (author's transl)]

In 17 gynaecological departments of West-Berlin hospitals, 2940 laparotomies were done between 1960 and 1969 in women of at least 60 years of age, of which 331 (10,9%) were exploratory. Of these the postoperative mortality was 39,2% (130 cases). The fatal cases could be divided into 120 women suffering from inoperable malignant tumors, 7 from sigmoid diverticulitis and 3 from chromical gynaecological inflammatory tumors. The frequency of such critical exploratory laparotomies could be lowered partly by intensifying cancer routine check-up by specialists by more complex diagnostic measures before the operations and by fewer adhesiotomies in cases of chronical inflammatory complaints. Most important, however, seems to be the well indicated application of laparoscopy under conditions that allow consecutive laparotomy if necessary. It is thought that to an experienced surgeon the diagnostic value of laparoscopy is almost equal to that of laparotomy. It therefore can be considered a true alternative.