THE number of elderly patients who have to undergo operation is steadily increasing year by year. Despite this, detailed studies of the metabolic effects of surgery in this age-group are relatively few. Calcium and phosphorus are little mentioned and we have found no records of the effect of differing degree of severity of operation upon the metabolism of these elements.This paper presents the results of metabolic balance studies on 15 patients over 60 years of age, and emphasizes the effects of differing degrees of severity of 'soft-tissue' surgery upon calcium and phosphorus metabolism.The information is important as a basis for the further study and conclusions of results of operations on the bony skeleton, as well as supplying essential information on the metabolic changes following surgery in this age-grmp. The preoperative portions of the study also add to the scanty data on 'normal' mineral metabolism in elderly patients in this country.
M E T H O D S Patient Selection.-Fifteenpatients over 60 years of age of both sexes were selected randomly, the only criteria being those of good nutritional status, and the absence of overt cardiac or renal disease. A subdivision was made into three groups of five, classified as 'mild', 'moderate', and 'severe' trauma. This grading is, of course, subjective, being dependent upon the criteria of a single surgeon who carried out all the operations.Mild trauma (all males) included appendicectomy, herniorrhaphy, and excision of fistula-in-ano. Moderate trauma (z males) included lumbar sympathectomy, uncomplicated cholecystectomy, vagotomy, and gastro-enterostomy. Severe trauma (2 males) included hemicolectomy, abdominoperineal resection of rectum ( 2 ) , and partial gastrectomy.