Lindmark G, Pählman L, Enblad P, Glimelius B
Department of Surgery, Akademiska sjukhuset, University of Uppsala, Sweden.
Acta Chir Scand. 1988 Nov-Dec;154(11-12):659-63.
In 545 consecutive patients undergoing elective or emergency surgery for colorectal cancer (370 colon and 175 rectum), mortality and morbidity were analysed in different age groups with special reference to patients over 80 years old. In that group, 33% had an emergency operation, compared with 18% below that age. Postoperative mortality after elective surgery ranged from 3 to 11% in the different age groups, but was not significantly related to age. In contrast, postoperative in-hospital mortality after emergency surgery was high (38%) among those older than 80 years, compared with 6% below 75 years and 24% between 76 and 80 years. Postoperative morbidity, i.e. infections and cardiovascular disease, increased with age, as did the length of hospital stay. Five-year survival, independent of age, was poorer after emergency surgery than after elective surgery. It is concluded that elective colorectal resection for cancer in elderly patients is a safe procedure.
对545例接受择期或急诊结直肠癌手术的患者(370例结肠癌和175例直肠癌)进行分析,特别针对80岁以上患者,在不同年龄组中分析死亡率和发病率。在该组中,33%的患者接受了急诊手术,而该年龄以下患者的这一比例为18%。择期手术后不同年龄组的术后死亡率在3%至11%之间,但与年龄无显著相关性。相比之下,80岁以上患者急诊手术后的院内死亡率较高(38%),75岁以下患者为6%,76至80岁患者为24%。术后发病率,即感染和心血管疾病,随年龄增加而增加,住院时间也随年龄增加。无论年龄如何,急诊手术后的五年生存率均低于择期手术后。结论是,老年患者择期结直肠癌切除术是一种安全的手术。