Gynecologic surgery in the aged

Aged women, those over 75 years, experience a high incidence of nearly all gynecologic neoplasms as well as associated chronic medical illnesses. In this study, 773 women underwent major surgery, while 711 underwent minor procedures. Fifty-two patients (3.5%) were 75 years of age or older. Forty-three of the 52 (83%) had a total of 119 associated medical complications. Eighty-nine surgical procedures were performed. A total of 17 postoperative complications occurred in 15 patients. Thirty-eight patients (73%) had no postoperative complications. One patient died because of infarction of the bowel diagnosed within 30 days of her primary surgical procedure. The aged patients in this study did well postoperatively with routine preoperative medical evaluation and postoperative care. Same-day admission and surgery did not increase morbidity. Aged patients can safely undergo major pelvic and abdominal surgery at a community medical center if one manages their associated medical conditions in a routine manner similar to that utilized in younger patients with similar problems. The associated medical complications and not age per se should be the deciding factor.