Bei 224 von 873 Patienten mit einer pathologischen Adipositas wurde während 3 Jahren laparoskopisch das justierbare Magenband implantiert. Sieben Operateure waren beteiligt. Operationstechnisch bedingte Probleme sind: frühe Pouchdilatation, Magenslipping, Magenperforation, Bandpenetration, Portinfekt, Portpenetration, Bandkatheterdefekt. Diese lassen sich mit Sorg und zunehmender Erfahrung vermeiden. Die späte Pouchdilatation und unzureichende Gewichtsreduktion sind durch ungenügende Compliance seitens der Patienten bedingt. Kritische Patientenselektion ist erforderlich. Bei einer Gesamtmorbidität von 19 % und Letalität von 0,4 % beträgt die durchschnittliche prozentuale Reduktion des Übergewichtes in 2 Jahren 50 ± 28 %. Die Ergebnisse lassen sich durch strenge Patientenauswahl und große operative Routine verbessern.

During 3 years, the adjustable gastric band (AGSB) was laparoscopically implanted in 224 of 873 patients with morbid obesity. The operation was done by 7 surgeons. Problems arising from the operative technique are: early pouch dilatation, gastric slippage, gastric perforation, penetration of the band, port infection, penetration of the port, defect of the band catheter. These can be avoided by care and increasing experience. The late pouch dilatation and the insufficient loss of excess weight arise from the unsatisfactory compliance of the patient. Critical selection of patients is necessary. Total morbidity in this seria was 19%, the letality 0.4% and the average excess weight loss within 2 years was 50 +/- 28%. The results may be improved by restrictive selection of patients and great operative routine.

Summ.:The percentage of elderly people among surgical patients has been continuously rising. The purpose of this study was to show the course of operation and hospitalization of seniors in a department for general surgery. 191 patients aged 75 or older underwent surgery during the six months of observation. Information about preoperative social and environmental conditions, operative and postoperative treatments, complications, secondary symptoms and rehabilitation and homecare after discharge was retrospectively compiled. Women comprised 76.4%(146 cases) of the patients; men 23.6% (45 cases). Mandatory surgery was necessary in 37.7% of all operations, while 62.3% were required to be handled on an emergency basis. The average age was 83.2 years (+/- 5.26). 33 (17.3%) of the patients on whom had been operated did not survive. 84.8% (28) of these cases had undergone emergency surgery, 15.2% (5) had been operated on routinely. For 66% (126) of the patients the course of hospitalization was without any complications.Discharge into the accustomed environment was possible for 74.7% (118) of the successful cases. Old patients show a good physical and psychological acceptance of surgery and hospitalization, if they are well prepared and secondary symptoms are appropriately therapied. The decision for routine operation in sufficient time can help avoid an emergency operation with poor prognosis.

The percentage of elderly people among surgical patients has been continuously rising. The purpose of this study was to show the course of operation and hospitalization of seniors in a department for general surgery. 191 patients aged 75 or older underwent surgery during the six months of observation. Information about preoperative social and environmental conditions, operative and postoperative treatments, complications, secondary symptoms and rehabilitation and homecare after discharge was retrospectively compiled. Women comprised 76.4% (146 cases) of the patients; men 23.6% (45 cases). Mandatory surgery was necessary in 37.7% of all operations, while 62.3% were required to be handled on an emergency basis. The average age was 83.2 years (+/- 5.26). 33 (17.3%) of the patients on whom had been operated did not survive. 84.8% (28) of these cases had undergone emergency surgery, 15.2% (5) had been operated on routinely. For 66% (126) of the patients the course of hospitalization was without any complications. Discharge into the accustomed environment was possible for 74.7% (118) of the successful cases. Old patients show a good physical and psychological acceptance of surgery and hospitalization, if they are well prepared and secondary symptoms are appropriately therapied. The decision for routine operation in sufficient time can help avoid an emergency operation with poor prognosis.