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老年患者腹腔镜辅助胃切除术手术并发症的危险因素

Risk factors for operative complications in elderly patients during laparoscopy-assisted gastrectomy.

作者信息

Hwang Sun-Hwi, Park Do Joong, Jee Ye Seob, Kim Hyung-Ho, Lee Hyuk-Joon, Yang Han-Kwang, Lee Kuhn Uk

机构信息

Department of Surgery, Seoul National University Bundang Hospital, Gyeonggi, Korea.

出版信息

J Am Coll Surg. 2009 Feb;208(2):186-92. doi: 10.1016/j.jamcollsurg.2008.10.023. Epub 2008 Dec 18.

Abstract

BACKGROUND

We evaluated the feasibility of laparoscopy-assisted gastrectomy in elderly patients with gastric cancer.

STUDY DESIGN

We performed a retrospective analysis of 632 patients who underwent laparoscopy-assisted gastrectomy from May 2003 to December 2007 at Seoul National University Bundang Hospital. Postoperative complication rates were compared between patients older and younger than 70 years of age.

RESULTS

Of the 632 patients, 515 (81.5%) were younger than 70 years and 117 (18.5%) were aged 70 years or older. Significant differences in the prevalence of cardiovascular disease and hypertension were observed in patients older than 70 years (p < 0.05). Although the overall complication rates of the patients younger and older than 70 years were 12.6% and 17.9%, respectively, there was no statistically significant difference between groups (p=0.12). Multiple logistic regression analysis revealed that comorbidities with hypertension or with liver cirrhosis were the only variables that correlated independently with postoperative complications.

CONCLUSIONS

Complications after laparoscopy-assisted gastrectomy for patients older than 70 years of age with gastric cancer were similar to those of younger patients. But a careful approach is required when patients older than 70 years of age have hypertension or liver cirrhosis.

摘要

背景

我们评估了腹腔镜辅助胃癌切除术在老年胃癌患者中的可行性。

研究设计

我们对2003年5月至2007年12月在首尔国立大学盆唐医院接受腹腔镜辅助胃癌切除术的632例患者进行了回顾性分析。比较了年龄在70岁及以上和70岁以下患者的术后并发症发生率。

结果

632例患者中,515例(81.5%)年龄小于70岁,117例(18.5%)年龄在70岁及以上。70岁以上患者的心血管疾病和高血压患病率存在显著差异(p < 0.05)。虽然70岁及以下和70岁以上患者的总体并发症发生率分别为12.6%和17.9%,但两组之间无统计学显著差异(p = 0.12)。多因素logistic回归分析显示,高血压或肝硬化合并症是与术后并发症独立相关的唯一变量。

结论

70岁以上老年胃癌患者腹腔镜辅助胃癌切除术后的并发症与年轻患者相似。但70岁以上患者合并高血压或肝硬化时,需要谨慎处理。

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