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老年直肠癌患者术后肺部并发症：一项对477例连续病例的多中心研究中腹腔镜与开放手术入路的评估

Pulmonary Complications after Surgery for Rectal Cancer in Elderly Patients: Evaluation of Laparoscopic versus Open Approach from a Multicenter Study on 477 Consecutive Cases.

作者信息

Milone Marco, Elmore Ugo, Vignali Andrea, Mellano Alfredo, Gennarelli Nicola, Manigrasso Michele, Milone Francesco, De Palma Giovanni Domenico, Muratore Andrea, Rosati Riccardo

机构信息

Department of Surgical Specialities and Nephrology, University of Naples "Federico II", Naples, Italy.

Department of Gastrointestinal Surgery, San Raffaele Hospital, Milan, Italy.

出版信息

Gastroenterol Res Pract. 2017;2017:5893890. doi: 10.1155/2017/5893890. Epub 2017 Oct 22.

DOI:10.1155/2017/5893890
PMID:29201047
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5671719/
Abstract

AIM

To evaluate the impact of open or laparoscopic rectal surgery on pulmonary complications in elderly (>75 years old) patients.

METHODS

Data from consecutive patients who underwent elective laparoscopic or open rectal surgery for cancer were collected prospectively from 3 institutions. Pulmonary complications were defined according to the ACS/NSQUIP definition.

RESULTS

A total of 477 patients (laparoscopic group: 242, open group: 235) were included in the analysis. Postoperative pulmonary complications were significantly more common after open surgery (8 out of 242 patients (3.3%) versus 23 out of 235 patients (9.8%); = 0.005). In addition, PPC occurrence was associated with the increasing of postoperative pain (5.04 ± 1.62 versus 5.03 ± 1.58; = 0.001) and the increasing of operative time (270.06 ± 51.49 versus 237.37 ± 65.97; = 0.001).

CONCLUSION

Our results are encouraging to consider laparoscopic surgery a safety and effective way to treat rectal cancer in elderly patients, highlighting that laparoscopic surgery reduces the occurrence of postoperative pulmonary complications.

摘要

目的

评估开放或腹腔镜直肠手术对老年（>75岁）患者肺部并发症的影响。

方法

前瞻性收集来自3家机构的连续接受择期腹腔镜或开放直肠癌手术患者的数据。肺部并发症根据美国外科医师学会/国家外科质量改进计划（ACS/NSQUIP）的定义确定。

结果

共有477例患者（腹腔镜组：242例，开放组：235例）纳入分析。开放手术后术后肺部并发症明显更常见（242例患者中有8例（3.3%），而235例患者中有23例（9.8%）；P = 0.005）。此外，肺部并发症的发生与术后疼痛增加（5.04±1.62对5.03±1.58；P = 0.001）和手术时间增加（270.06±51.49对237.37±65.97；P = 0.001）相关。

结论

我们的结果令人鼓舞，表明腹腔镜手术是治疗老年患者直肠癌的一种安全有效的方法，突出显示腹腔镜手术可减少术后肺部并发症的发生。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/382a/5671719/7716080640f1/GRP2017-5893890.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/382a/5671719/1e1c6faaf9b9/GRP2017-5893890.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/382a/5671719/7716080640f1/GRP2017-5893890.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/382a/5671719/1e1c6faaf9b9/GRP2017-5893890.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/382a/5671719/7716080640f1/GRP2017-5893890.002.jpg

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