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老年与青年患者直肠癌微创治疗效果的对比:一项回顾性研究。

Benefits of minimally invasive surgery for rectal cancer in older adults compared with younger adults: a retrospective study.

机构信息

Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, China.

Department of General Surgery, General Surgery Institute of Yangzhou, Yangzhou University, Northern Jiangsu People's Hospital, 98 Nantong West Road, Yangzhou, 225001, Jiangsu, China.

出版信息

J Robot Surg. 2023 Aug;17(4):1825-1833. doi: 10.1007/s11701-023-01602-1. Epub 2023 Apr 21.

Abstract

Randomized research demonstrated that robotic surgery was oncologically safe and beneficial in the short term. We investigated whether older adults benefit from robotics more than younger adults do in terms of short-term outcomes. We identified all older (≥ 70 years old) and younger (≤ 70) adults with rectal cancer treated with resection between 2019 and 2022 from an institutional database. We assessed the short-term post-operative 90-day outcomes, which included the first bowel movement, length of hospital duration, sepsis, and harvested lymph node on an age-based differentiation. The key outcomes were complications and grades III-IV on the Clavien-Dindo scale. We identified 298 individuals treated with oncologic resection of rectal cancer: 108 (36.6%) were older adults, while 190 (63.4%) were younger adults. Older adults treated with robotic surgery include 45 (41.6%), whereas 63 (58.3%) older adults were treated with laparoscopic surgery, and 85 (44.7%) younger adults were treated with robotic surgery, while 105 (55.2%) younger adults were treated with laparoscopic surgery. The Clavien-Dindo grading system exposes a substantial P < 0.05 in younger group, whereas grade III-IV patients are seen more frequently in laparoscopic surgery than robotic surgery. Younger and older persons both benefited differently from robotic surgery when compared to laparoscopic surgery in terms of major post-operative complications.

摘要

随机研究表明,机器人手术在短期内具有肿瘤安全性和益处。我们研究了老年人是否比年轻人从机器人手术中获得更多的短期结果。我们从机构数据库中确定了所有在 2019 年至 2022 年间接受直肠切除术治疗的老年(≥70 岁)和年轻(≤70 岁)成年人。我们评估了短期术后 90 天的结果,包括第一次排便、住院时间、败血症和基于年龄的淋巴结采集。主要结果是并发症和 Clavien-Dindo 分级的 III-IV 级。我们确定了 298 名接受直肠恶性肿瘤切除术治疗的患者:108 名(36.6%)为老年人,190 名(63.4%)为年轻人。接受机器人手术治疗的老年人中包括 45 名(41.6%),而 63 名(58.3%)老年人接受腹腔镜手术治疗,85 名(44.7%)年轻人接受机器人手术治疗,而 105 名(55.2%)年轻人接受腹腔镜手术治疗。Clavien-Dindo 分级系统在年轻组中显示出显著的 P<0.05,而腹腔镜手术中 III-IV 级患者比机器人手术更常见。与腹腔镜手术相比,机器人手术在主要术后并发症方面使年轻和老年患者都获得了不同的益处。

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