Surgery in patients with acquired immunodeficiency syndrome
G. Robinson, S. E. Wilson and R. A. Williams
Between 1982 and 1985, 21 patients with acquired immunodeficiency syndrome
(20 men and one woman; mean age, 36 years) underwent 31 surgical procedures
at the Harbor/UCLA Medical Center, Torrance, or the UCLA Medical Center
(skin, lymph node, and endoscopic biopsies were excluded). The operations
included seven emergencies and 24 elective operations (eight major and 16
minor). Pathologic findings included cytomegalovirus colon perforation
(two), disseminated Kaposi's sarcoma (KS) of the small and large bowel
(one), cystic duct obstruction by KS (one), poorly differentiated
gastrointestinal lymphoma (one), Candida acalculous cholecystitis (one),
central nervous system toxoplasmosis (two), amebic encephalitis with
abscess (one), staphylococcal botryomycosis of the pericardium (one),
pulmonary KS (one), and cytomegalovirus (one). The overall operative (30
days) mortality rate was 48% (10/21). The emergency surgery rate was 57%
(4/7), elective, 43% (6/14). The high operative mortality rate in these
patients was usually due to progression of opportunistic infections or
malignancy.
