Troian Marina, Bellio Gabriele, Pasquali Arianna, de Manzini Nicolò
Department of General Surgery, University Hospital of Trieste, Trieste, Italy.
Department of General Surgery, University Hospital of Trieste, Trieste, Italy -
Minerva Chir. 2018 Feb;73(1):20-28. doi: 10.23736/S0026-4733.17.07417-X. Epub 2017 Nov 20.
The role of laparoscopic surgery for pT3/pT4 colorectal cancer (CRC) is still under debate. The aim of this study was to compare the outcomes of laparoscopic and open procedures for pT3/pT4 CRC in elderly patients.
From January 2004 to December 2015, 225 patients aged ≥70 years underwent elective colorectal surgery for pT3/pT4 CRC at the Department of General Surgery, University Hospital of Trieste. Patients' demographics, tumor's characteristics, intraoperative factors, short-term and long-term outcomes were retrospectively analyzed.
The study included 113 patients undergone open surgery and 112 who underwent laparoscopic surgery. Age was found to be statistically different between the two group, with open surgery patients being older than laparoscopic ones (P=0.009). The tumor location differed between the two groups (P=0.004), determining a variation in the incidence of surgical procedures performed (P<0.001). No other statistically significant differences were found in terms of intraoperative, histopathologic and oncologic factors.
Laparoscopy is as safe as open surgery for pT3/pT4 CRC and it is often feasible, though in old patients higher conversion rates should be anticipated than in younger ones.
腹腔镜手术在pT3/pT4期结直肠癌（CRC）治疗中的作用仍存在争议。本研究旨在比较老年患者pT3/pT4期CRC腹腔镜手术与开放手术的疗效。
2004年1月至2015年12月，的里雅斯特大学医院普通外科225例年龄≥70岁的患者因pT3/pT4期CRC接受择期结直肠手术。对患者的人口统计学资料、肿瘤特征、术中因素、短期和长期疗效进行回顾性分析。
该研究纳入113例行开放手术的患者和112例行腹腔镜手术的患者。发现两组患者年龄存在统计学差异，开放手术患者年龄大于腹腔镜手术患者（P=0.009）。两组肿瘤位置不同（P=0.004），导致所施行手术的发生率存在差异（P<0.001）。在术中、组织病理学和肿瘤学因素方面未发现其他统计学显著差异。
对于pT3/pT4期CRC，腹腔镜手术与开放手术一样安全，且通常可行，不过老年患者的中转率应高于年轻患者。
