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65岁以上患者的结直肠手术

[Colorectal surgery in patients over 65 years of age].

作者信息

Herrera-Gómez A, Orozco C, Ruíz-Molina J M, Téllez-Palacios D, Ortega-Gutiérrez C, Namendys-Silva S A

机构信息

Subdirección de Cirugía, Instituto Nacional de Cancerología, México DF, México. herrera

出版信息

Rev Gastroenterol Mex. 2012 Jul-Sep;77(3):119-24. doi: 10.1016/j.rgmx.2012.04.009. Epub 2012 Aug 9.

Abstract

BACKGROUND

There is a limited functional reserve in patients over 65 years of age which is conducive to more frequent postoperative complications. Disease extension at the time of diagnosis (clinical stage) and complete tumor resection are two independent risk factors that have a direct influence on survival.

AIMS

To describe the factors that influence morbidity and mortality in patients over 65 years of age after colorectal surgery.

MATERIAL AND METHODS

A retrospective, observational, descriptive study was carried out within the time frame of January 2004 and December 2009 on 105 colon cancer patients after colorectal surgery. They were divided into two groups, one under 65 years of age and the other over 65 years of age, in order to compare preoperative comorbidity, as well as morbidity and mortality 30 days after surgery.

RESULTS

Of the 105 patient total (53,3%), 56 were ≤ 65 years of age. There were complications in 42,8% of the patients, and those of early and less severe presentation were the most frequent; late complications were more frequent in patients ≤ 65 vs > 65 years of age (16,0% vs 10,2%). Overweight (BMI > 25 kg/m(2)) was observed in 35,0% of the study population. Patients > 65 years of age had fewer comorbidities. The most common causes of reintervention were anastomosis dehiscence and postoperative hemorrhage. Mortality in the group was 6,6% and sepsis was the most frequent cause of death.

CONCLUSIONS

Colorectal surgery in patients over 65 years of age has an acceptable complication frequency and a low mortality rate. Our results suggest that patients older than 65 years of age be treated with the same prospects for cure as younger patients.

摘要

背景

65岁以上患者的功能储备有限,这使得术后并发症更频繁发生。诊断时的疾病范围(临床分期)和肿瘤完全切除是对生存有直接影响的两个独立危险因素。

目的

描述影响65岁以上患者结直肠手术后发病率和死亡率的因素。

材料与方法

在2004年1月至2009年12月期间,对105例结直肠癌患者进行了结直肠手术后的回顾性、观察性、描述性研究。将他们分为两组,一组年龄在65岁以下,另一组年龄在65岁以上,以比较术前合并症以及术后30天的发病率和死亡率。

结果

105例患者中,56例(53.3%)年龄≤65岁。42.8%的患者出现并发症,早期和较轻表现的并发症最为常见;65岁以下患者的晚期并发症比65岁以上患者更频繁(16.0%对10.2%)。35.0%的研究人群超重(BMI>25 kg/m²)。65岁以上患者的合并症较少。再次干预的最常见原因是吻合口裂开和术后出血。该组的死亡率为6.6%,败血症是最常见的死亡原因。

结论

65岁以上患者的结直肠手术并发症发生率可接受,死亡率低。我们的结果表明,65岁以上的患者应与年轻患者一样接受相同的治愈前景治疗。

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