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[腹腔镜手术治疗80岁以上老年结直肠癌患者的疗效]

[Efficacy of Laparoscopic Surgery for Elderly Patients with Colorectal Cancer Over 80 Years Old].

作者信息

Yoshimatsu Kazuhiko, Ito Yoshitomo, Kono Teppei, Maeda Hiroyuki, Imaizumi Rie, Koike Taro, Sano Megumi, Satake Masaya, Yamada Yasufumi, Okayama Sachiyo, Yokomizo Hajime, Shimakawa Takeshi, Katsube Takao, Shiozawa Shunichi

机构信息

Dept. of Surgery, Saitamaken Saiseikai Kurihashi Hospital.

出版信息

Gan To Kagaku Ryoho. 2019 Dec;46(13):2506-2508.

Abstract

The efficacy of laparoscopic surgery for elderly patients aged over 80 years who have colorectal cancer was investigated concerning complications. Sixty-five patients over 80 years old who underwent colorectal cancer resection until January 2018 were enrolled. Factors that led to complication were analyzed retrospectively. Thirty-three men and 32 women were included, with a median age of 83 years. Forty-eight cases were located at the colon; and 17, at the rectum. The median operating time was 164 minutes, including 39 cases treated with the laparoscopic approach. Postoperative complications were observed in 28 cases(43.1%), of which 15(23.1%)had a Clavien-Dindo(CD)classification of Grade BⅡ. These cases had significantly prolonged postoperative hospital stay. Complications included 10 cases of incisional surgical site infection(SSI), 9 cases of ileus, 6 cases of melena, 2 cases of urinary infection, 2 cases of urinary disorder, and 1 case of postoperative death. Open surgery was the only significant factor associated with the incidence of CD classification of BⅡ(p=0.0330). Among the complications, the incisional SSI was reduced by laparoscopic surgery(p=0.0050). The number of laparoscopic surgeries reduced the incidence of CD classification BⅡ of complications in elderly patients aged over 80 years who had with colorectal cancer resection. The use of incisional SSI also decreased with the use of laparoscopic surgery. Laparoscopic surgery for colorectal cancer in elderly patients may lead to reduced complication rates.

摘要

针对并发症情况,对80岁以上老年结直肠癌患者行腹腔镜手术的疗效进行了调查。纳入了截至2018年1月接受结直肠癌切除术的65例80岁以上患者。对导致并发症的因素进行了回顾性分析。其中男性33例,女性32例,中位年龄83岁。48例位于结肠,17例位于直肠。中位手术时间为164分钟,其中39例采用腹腔镜手术治疗。28例(43.1%)出现术后并发症,其中15例(23.1%)Clavien-Dindo(CD)分级为BⅡ级。这些病例术后住院时间显著延长。并发症包括10例手术切口部位感染(SSI)、9例肠梗阻、6例黑便、2例泌尿系统感染、2例泌尿系统功能障碍和1例术后死亡。开放手术是与CD分级BⅡ级发生率相关的唯一显著因素(p=0.0330)。在并发症中,腹腔镜手术降低了手术切口SSI的发生率(p=0.0050)。腹腔镜手术减少了80岁以上老年结直肠癌切除患者并发症CD分级BⅡ级的发生率。腹腔镜手术的应用也降低了手术切口SSI的发生率。老年患者结直肠癌的腹腔镜手术可能会降低并发症发生率。

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