Extensive gynecologic surgical procedures upon patients more than 75 years of age

A series of 110 patients upon whom extensive gynecologic surgical procedures were performed between 1971 and 1986 are presented. All of the patients were 75 years of age or older at the time of operation. Abdominal surgical procedures were performed upon 49, and vaginal hysterectomies were performed upon the remaining 61. Among patients undergoing abdominal procedures, three deaths occurred; among those undergoing vaginal hysterectomies, one patient died (6.2 versus 1.6 per cent). Morbidity was high among both groups (43.5 per cent, abdominal group). Patients undergoing the vaginal procedure stayed in the hospital fewer days (9.6 versus 14.5 days). From this data, it is concluded that, if there is a clear indication for surgical procedure, it should be performed, regardless of the age of the patient, if there is no equal or superior medical alternative and if there is no absolute contraindication to anesthesia.