摘要
目的探讨腹腔镜手术治疗70岁以上老年人结直肠肿瘤的安全性。方法回顾性总结113例腹腔镜辅助和开腹结直肠手术治疗70岁以上老年人结直肠肿瘤的经验,比较腹腔镜手术组(腹腔镜组)35例、传统开腹手术组(开腹组)78例和65岁以下腹腔镜手术组(对照组)35例的手术安全性、并发症及随访结果等情况。结果腹腔镜组、对照组无手术相关死亡患者,开腹组有2例因术后肺部感染而死亡。腹腔镜组有7例(20.0%)发生术后并发症,显著少于开腹组的33例(42.3%)(P<0.05).而与对照组的3例(8.6%)比较,差异无统计学意义。腹腔镜组术中出血、排气时间与进食半流质时间分别为(92±50)ml、(2±1)d 和(5±2)d,与开腹组(156±119)ml、(3±3)d和(6±1)d 比较,差异有统计学意义(P<0.05)。腹腔镜组与对照组手术时间、术中出血及主要并发症差异无统计学意义(P>0.05)。腹腔镜组与开腹组短期内(30个月)肿瘤局部复发、远处转移率类似,累计生存率(仅肿瘤相关死亡)分别为80.4%与82.1%,差异无统计学意义。结论腹腔镜手术治疗70岁以上老年人结直肠癌安全、有效,是治疗老年人结直肠肿瘤较好的选择方法。
Objective To evaluate the safety, surgery for elderly patients with colorectal cancer. efficacy and advantages of laparoscopic colorectal Methods Operation safety, complications, and postoperative recovery of 35 patients aged 70 years and over who underwent laparoscopic colorectal surgery（LAPA group） were analyzed retrospectively and compared with those of 78 elderly patients performed with conventional open surgery（OPEN group） and 35 patients younger than 65 years performed with laparoscopic colorectal surgery（LAPB group） between December 2002 and December 2003. Results No surgery-related death occurred in LAPA group and LAPB group, but 2 deaths were found in OPEN group because of severe pulmonary infection and anastomotic leakage respectively. There were 33 （42.3%） cases of complications in the OPEN group which were significantly more than those in LAPA and LAPB group （P〈0.05）. Mean blood loss, time to flatus and time to normal diet of LAPA group were（92±50）ml, （2±1）days, and（5±2）days respectively, which were significantly less than those of OPEN group （P〈 0.05）. No significant difference was found between LAPA group and LAPB group in terms of mean operation time, blood loss and complications（all P〈 0.05）. Local recurrence rate, metachronous metastases rate and cumulative survival probability at 30 months were similar in the LAPA and OPEN groups. Conclusions Laparoscopic colorectal surgery is safe and beneficial to the patients aged 70 years and over and it could be adopted widely.
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2006年第2期113-116,共4页
Chinese Journal of Geriatrics
关键词
腹腔镜手术
结直肠肿瘤
Laparoscopic surgery
Colorectal neoplasms
