Li Jin, Yudong Lin, Chen Yong
Department of Surgical Oncology, Ningde Municipal Hospital, Fujian Medical University Ningde 352100, Fujian Province, People's Republic of China.
J BUON. 2018 Nov-Dec;23(6):1625-1632.
This study was designed to compare the short- and long-term outcomes between elderly and middle-aged patients who underwent laparoscopic complete mesocolic excision for right colon cancer.
A retrospective analysis was performed on the clinical and follow-up data of 108 patients undergoing laparoscopic complete mesocolic excision at our institution between January 2012 and January 2018. Patients were grouped according to their age at the time of operation into the elderly group (≥ 70 years old, 46 cases) and the middle-aged group (55 years old ≤ age ≤ 69 years old, 62 cases). Comparisons of short- and long-term outcomes were done between these two groups.
When comparing baseline data, the Charlson comorbidity index and American Society of Anesthesiologists (ASA) scores were higher among elderly patients. Comparisons of other baseline data showed no statistically significant differences. With the exception of a higher intraoperative blood loss recorded among elderly patients, comparisons of other short-term outcomes such as operation duration, blood transfusion rate, conversion to open surgery, incidence and severity of complications 30 days after surgery, pathological results, and compliance with chemotherapy showed no statistically significant differences. Long-term follow-up results indicated that recurrences were somewhat similar between these two groups of patients. Multivariate analysis revealed that age was not an independent predictor of overall survival (OS) or disease-free survival (DFS).
Similar short- and long-term outcomes can be achieved among elderly and middle-aged patients with right colon cancer who underwent laparoscopic complete mesocolic excision. Age is not a limiting factor in the application of laparoscopic complete mesocolic excision.
本研究旨在比较接受腹腔镜全结肠系膜切除术治疗右结肠癌的老年患者和中年患者的短期及长期预后。
对2012年1月至2018年1月在我院接受腹腔镜全结肠系膜切除术的108例患者的临床和随访数据进行回顾性分析。根据手术时的年龄将患者分为老年组（≥70岁，46例）和中年组（55岁≤年龄≤69岁，62例）。对这两组患者的短期和长期预后进行比较。
比较基线数据时，老年患者的Charlson合并症指数和美国麻醉医师协会（ASA）评分较高。其他基线数据的比较未显示出统计学上的显著差异。除老年患者术中出血量较多外，手术时长、输血率、转为开放手术、术后30天并发症的发生率和严重程度、病理结果以及化疗依从性等其他短期预后的比较均未显示出统计学上的显著差异。长期随访结果表明，这两组患者的复发情况 somewhat similar。多因素分析显示，年龄不是总生存期（OS）或无病生存期（DFS）的独立预测因素。
接受腹腔镜全结肠系膜切除术治疗的右结肠癌老年患者和中年患者可获得相似的短期和长期预后。年龄不是腹腔镜全结肠系膜切除术应用的限制因素。
