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老年上段直肠癌患者行小切口腹腔镜手术的近期和中期疗效:一项回顾性队列研究。

Short- And medium-term outcomes of reduced-port laparoscopic surgery in elderly patients with upper rectal cancer: A retrospective cohort study.

机构信息

Department of Surgery, Wenling First People's Hospital, Wenling City, People's Republic of China.

出版信息

Cancer Med. 2020 Aug;9(15):5320-5326. doi: 10.1002/cam4.3070. Epub 2020 Jun 3.

Abstract

BACKGROUND

To investigate the short- and medium-term outcomes of using a reduced-port laparoscopic surgery (RPLS), compared to multi-port laparoscopic surgery (MPLS), for the treatment of upper rectal cancer (URC) among elderly patients.

METHODS

We conducted a retrospective analysis of the clinical and follow-up data of 181 elderly patients with URC, who underwent radical laparoscopic surgery at our hospital, between January 2015 and January 2019. Among these 181 cases, 62 underwent RPLS and 119 MPLS.

RESULTS

Compared to MPLS, RPLS decreased the length of surgical incision, lower pain on postoperative days 1 and 2, decreased the time to first flatus after surgery, as well as the time to mobilization after surgery. There was no difference between the short-term outcomes between the two laparoscopic approaches, and no difference in the 3-year disease-free and overall survival rate.

CONCLUSION

Compared to MPLS, RPLS provides several advantages for the treatment of URC among elderly individuals, including a shorter length of surgical incision, reduced postoperative pain, shorter time to first flatus after surgery, earlier mobilization, and better cosmetic outcomes. These advantages are achieved with no difference in the length of surgery, nor in the 3-year disease-free and overall survival rate, compared to MPLS.

摘要

背景

为了研究与多孔腹腔镜手术(MPLS)相比,使用小切口腹腔镜手术(RPLS)治疗老年高位直肠癌(URC)的短期和中期效果。

方法

我们对 2015 年 1 月至 2019 年 1 月期间在我院接受根治性腹腔镜手术的 181 例老年 URC 患者的临床和随访资料进行回顾性分析。其中 62 例行 RPLS,119 例行 MPLS。

结果

与 MPLS 相比,RPLS 降低了手术切口长度,术后第 1、2 天疼痛减轻,术后首次排气时间和术后活动时间缩短。两种腹腔镜方法的短期结果无差异,3 年无病生存率和总生存率也无差异。

结论

与 MPLS 相比,RPLS 为老年 URC 患者的治疗提供了几个优势,包括手术切口更短、术后疼痛减轻、术后首次排气时间更早、术后活动更早、美容效果更好。与 MPLS 相比,RPLS 在手术时间和 3 年无病生存率和总生存率方面没有差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f04/7402837/0b242b47a950/CAM4-9-5320-g001.jpg

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