Laparoscopic bilateral salpingo-oophorectomy for women aged 70 and older

Abstract

Objective: We retrospectively assessed perioperative risk for laparoscopic salpingo-oophorectomy in elderly women.
Design: We performed 13 laparoscopic salpingo-oophorectomy procedures in women aged 70 and older. During the same period, 18 patients aged 45 to 59 also underwent bilateral laparoscopic salpingo-oophorectomy. We defined the latter group of patients as the control group. We compared the older group with the control group with regard to underlying diseases, preoperative evaluations, surgical methods, intraoperative complications, postoperative complications, and hospitalization.
Results: The median age of the older patients was 74 years (range, 70-83 years). Ten of the 13 older patients had an underlying disease. Three patients were obese (Body Mass Index > 25). Four patients received perioperative anticoagulant therapy. All of the tumors were benign in the final pathological diagnosis. For the laparoscopic procedure, abdominal air pressure was fixed at 8 mmHg. All of the patients underwent surgery only under general anesthesia. The average duration of the operation was 110 min (range, 46-110 min). Average blood loss was 16 ml (range, 0-140 ml). No perioperative complications were observed. All of the patients began walking 1 day after surgery. The median inpatient hospital stay was 4 days (range, 3-7 days). Two patients had subcutaneous hematoma as a postoperative complication, which did not need any treatment or postponement of hospital discharge. Comparisons between the older group and control group revealed that only the rate of underlying disease was significantly different.
Conclusion: Laparoscopic salpingo-oophorectomy for aged women must be conducted cautiously because such patients have a high prevalence of underlying disease. Almost all of the procedures were conducted safely, suggesting that this surgical indication could be expanded for aged women.