General Surgery Department, University Hospital of Larissa, Mezourlo, 41110 Larissa, Greece.
Tech Coloproctol. 2011 Oct;15 Suppl 1:S47-50. doi: 10.1007/s10151-011-0751-z.
The purpose of this study was to evaluate the outcomes of colorectal cancer surgery among the elderly.
From March 2002 until February 2010, 434 patients who presented to our institution with the initial diagnosis of colorectal cancer and were submitted to open curative colorectal cancer resections or some kind of palliative procedure either elective or emergencies were retrospectively reviewed. A total of 286 of these patients (65.8%) were below 75 years (group A) and 148 (34.2%) above 75 years (group B).
A procedure with curative intent was undertaken in 386 patients (88.9%), while forty-eight patients (11.1%) were submitted to a palliative procedure. Regarding the incidence of emergency operations, forty-five patients (15.7%) from group A and forty-four patients (29.7%) from group B were operated due to an emergency (obstructing, perforating or bleeding tumors; P < 0.001). Mean ASA score was 1.74 ± 0.84 and 2.32 ± 0.94 for groups A and B, respectively (P < 0.001). Mean TNM stage was 2.28 ± 1.00 and 2.74 ± 0.98 for groups A and B, respectively (P = 0.0001). Elderly patients exhibited increased incidence of post-operative complications and increased post-operative mortality compared with their younger counterparts (P = 0.002 and 0.001, respectively).
Colorectal cancer surgery in the elderly is a challenging clinical scenario. Treatment decision adjusted to each individual case is the ideal practice in order to maintain an acceptable balance between curative cancer resections and palliative procedures.
本研究旨在评估老年结直肠癌患者的手术治疗效果。
2002 年 3 月至 2010 年 2 月，回顾性分析了 434 例因结直肠癌初诊而在我院接受开放性根治性结直肠癌切除术或姑息性手术（包括择期和急诊）的患者。其中 286 例患者（65.8%）年龄小于 75 岁（A 组），148 例患者（34.2%）年龄大于 75 岁（B 组）。
386 例患者（88.9%）行根治性手术，48 例患者（11.1%）行姑息性手术。A 组 45 例（15.7%）和 B 组 44 例（29.7%）患者因急症（梗阻、穿孔或出血性肿瘤）而接受急诊手术（P < 0.001）。A 组和 B 组的平均 ASA 评分为 1.74 ± 0.84 和 2.32 ± 0.94（P < 0.001）。A 组和 B 组的平均 TNM 分期分别为 2.28 ± 1.00 和 2.74 ± 0.98（P = 0.0001）。与年轻患者相比，老年患者术后并发症发生率和死亡率均升高（P = 0.002 和 0.001）。
老年结直肠癌手术是一个具有挑战性的临床情况。针对每个患者制定个体化治疗决策是一种理想的实践方法，以便在根治性癌症切除术和姑息性手术之间取得可接受的平衡。
