Part 2 (2/2)
=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 circ.u.mstance that these women of eighty years and upwards must have been blessed with a stronger const.i.tution 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._, x.x.xvii. 152.
--+-------------+-----+--------+------------------------------------ 9
Kraft
84
R.
_Hospitalstidende_, Copenhagen.
--+-------------+-----+--------+------------------------------------ 10
Owens[1]
87
R.
_Lancet_, 1895, i. 542.
--+-------------+-----+--------+------------------------------------ 11
Thornton
94
R.
_Trans. Obstet. Soc._, x.x.xvii, 158.
--+-------------+-----+--------+------------------------------------ 12
Bland-Sutton
85
R.
Middles.e.x 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 cla.s.sification 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.
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