Ovariotomy in old age. In 1891 I was able to find twenty-two records of successful ovariotomy in women over seventy years of age. Since that date Howard A. Kelly and Mary Sherwood made a collective investigation, and succeeded in obtaining notes of one hundred cases of ovariotomy performed on women over seventy years of age: the death-rate amounted to 12%.
The subjoined table concerns itself with ovariotomy performed on women after the age of eighty years, and the results are remarkable, notwithstanding the circumstance that these women of eighty years and upwards must have been blessed with a stronger constitution than their contemporaries.
Ovariotomy in Women of Eighty Years of Age
| Reporter | Age | Result | Reference | |
|---|---|---|---|---|
| 1 | Owens | 80 | R. | Brit. Gyn. Soc. Journal, iv. 88. |
| 2 | Richardson | 80 | R. | Brit. Med. Journ., 1894, i. 523. |
| 3 | Heywood Smith | 81 | R. | Lancet, 1894, i. 1618. |
| 4 | Spencer | 82 | R. | Brit. Med. Journ., 1893, ii. 1271. |
| 5 | Homans | 82 | R. | Bost. Med. and Surg. Journ., 1888, 454. |
| 6 | Edis | 81 | R. | Brit. Med. Journ., 1892, i. 860. |
| 7 | Bush | 84 | R. | Ibid., 1894, ii. 67. |
| 8 | Remfrey | 83 | R. | Trans. Obstet. Soc., xxxvii. 152. |
| 9 | Kraft | 84 | R. | Hospitalstidende, Copenhagen. |
| 10 | Owens 1 | 87 | R. | Lancet, 1895, i. 542. |
| 11 | Thornton | 94 | R. | Trans. Obstet. Soc., xxxvii, 158. |
| 12 | Bland-Sutton | 85 | R. | Middlesex Hospital. |
| 1 A second operation on patient No. 1 in the list. | ||||
Mortality. The death-rate after ovariotomy is hard to estimate, especially as surgeons differ widely in the classification of the cases. In the simple and uncomplicated forms of ovarian cysts and tumours the operation should be almost free from risk. Many surgeons, excluding malignant conditions, have had lists of a hundred operations with no deaths.
If all kinds of tumours are included as represented in the table on [p. 17], a 5% mortality in experienced hands would be regarded as a good result. In general hospital work it is probably as high as 10%. With less experienced surgeons who do not perform many operations the death-rate will vary from 10 to 15%.
The risks and after-consequences of ovarian operations are set forth in Chapter XI.
References
Doran, A. On complete Intraperitoneal Ligature of the Pedicle in Ovariotomy. St. Bartholomew’s Hospital Reports, 1877, xiii. 195.