九旬老人的结直肠切除术：腹腔镜手术的有效性
Colorectal resection in nonagenarians: effectiveness of laparoscopic surgery.
作者信息
Soma Toshiya, Sugano Motoki, Kawasaki Chihiro, Tsuji Masae, Fukui Izumi
机构信息
Department of Surgery, Kansai Electric Power Hospital, Osaka, Japan; Department of Surgery, Obama Municipal Hospital, Obama, Japan; Department of Surgery, Moriyama Municipal Hospital, Moriyama, Japan.
出版信息
Asian J Endosc Surg. 2014 Aug;7(3):222-6. doi: 10.1111/ases.12105. Epub 2014 Apr 15.
INTRODUCTION
The number and proportion of elderly persons in the general population have been increasing. Inevitably, the incidence of colorectal carcinoma has also increased. Although substantial evidence indicates that surgery is well tolerated in patients 80 years or older, studies in nonagenarians are not well documented.
METHODS
Consecutive nonagenarians and octogenarians who underwent elective laparoscopic-assisted colectomy (LAC) from September 2009 through October 2011 were studied. Data on medical history, ASA score, details of operations, and postoperative events were collected.
RESULTS
LAC was performed in nine nonagenarians and seven octogenarians. There were no complications related to laparoscopy. No patient required conversion from LAC to an open procedure or died postoperatively. Peristalsis was confirmed and oral intake was initiated on postoperative days 2.6 and 2.7, respectively.
CONCLUSIONS
Laparoscopic surgery is considered an extremely useful treatment for very old patients because it has a low risk of postoperative complications, even in the presence of pre-existing diseases. We conclude that LAC may be indicated in nonagenarians.
引言
普通人群中老年人的数量和比例一直在增加。不可避免地，结直肠癌的发病率也有所上升。尽管大量证据表明80岁及以上患者对手术耐受性良好，但关于九旬老人的研究记录并不充分。
方法
对2009年9月至2011年10月期间接受择期腹腔镜辅助结肠切除术（LAC）的连续九旬老人和八旬老人进行了研究。收集了病史、美国麻醉医师协会（ASA）评分、手术细节和术后事件的数据。
结果
对9名九旬老人和7名八旬老人实施了LAC。没有与腹腔镜检查相关的并发症。没有患者需要从LAC转为开放手术或术后死亡。分别在术后第2.6天和2.7天确认了肠蠕动并开始经口进食。
结论
腹腔镜手术被认为是对高龄患者极为有用的治疗方法，因为即使存在既往疾病，其术后并发症风险也较低。我们得出结论，LAC可能适用于九旬老人。
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