Gurevitch Anne J, Davidovitch Baruch, Kashtan Hanoch
Department of Surgery B, Kaplan Medical Center, POB 1, Rehovot, 76100, Israel.
J Gastrointest Surg. 2009 Jan;13(1):100-4. doi: 10.1007/s11605-008-0643-3. Epub 2008 Aug 15.
Colorectal cancer is one of the commonest malignancies in the elderly and, as such, is a major cause of morbidity and mortality. There is no consensus yet if age itself is a risk factor for adverse outcome after colectomy. The aims of the study were to evaluate the impact of age on operative results of right colectomy for cancer and to define factors that influence the postoperative mortality in octogenarians.
Data of all patients who underwent right colectomy for colon cancer between January 2001 and December 2006 were collected retrospectively. Patients were divided into two groups: those who were 80 years and older and those who were less than 80 years old. Analysis included patients' demographics, comorbidities, American Society of Anesthesiologists class, functional status, mode of presentation, stage of disease, length of hospital stay, postoperative morbidity, and mortality.
A total of 124 consecutive patients with right colon cancer were operated. Control group included 84 patients less than 80 year old. Study group included 40 patients 80 years or older. In Cox multivariate regression analysis, poor functional status and emergent surgery were independent factors for postoperative mortality.
There was no significant difference in the outcome of elective right colectomy between elderly patients and their younger counterparts. Operative mortality of emergency surgery was significantly higher in octogenarians. Emergent setting and poor functional status are major risk factors for postoperative mortality.
结直肠癌是老年人中最常见的恶性肿瘤之一,因此是发病和死亡的主要原因。对于年龄本身是否是结肠切除术后不良结局的危险因素,目前尚无共识。本研究的目的是评估年龄对结肠癌右半结肠切除术手术结果的影响,并确定影响八旬老人术后死亡率的因素。
回顾性收集2001年1月至2006年12月期间所有接受结肠癌右半结肠切除术患者的数据。患者分为两组:80岁及以上的患者和80岁以下的患者。分析内容包括患者的人口统计学特征、合并症、美国麻醉医师协会分级、功能状态、临床表现方式、疾病分期、住院时间、术后发病率和死亡率。
共有124例连续性右结肠癌患者接受了手术。对照组包括84例80岁以下的患者。研究组包括40例80岁及以上的患者。在Cox多因素回归分析中,功能状态差和急诊手术是术后死亡的独立因素。
老年患者与年轻患者在择期右半结肠切除术的结果方面没有显著差异。八旬老人急诊手术的手术死亡率显著更高。急诊手术情况和功能状态差是术后死亡的主要危险因素。