Bokey E L, Chapuis P H, Fung C, Hughes W J, Koorey S G, Brewer D, Newland R C
Department of Colon and Rectal Surgery, University of Sydney, Concord Hospital, Australia.
Dis Colon Rectum. 1995 May;38(5):480-6; discussion 486-7. doi: 10.1007/BF02148847.
The aim of this study was to report the prevalence of postoperative complications and mortality of patients with colorectal cancer when treated by conventional surgery.
Morbidity and mortality following open resection for colorectal cancer were analyzed in 1,846 patients whose clinical, operative, and pathology data were prospectively documented over a 20-year period.
Mortality following elective resection of the left and right colon was low, whereas overall morbidity was high (37.2 percent). Respiratory and cardiac complications were especially common. Incidence of clinically significant leakage was similar following right (0.5 percent) or left (1.1 percent) hemicolectomy. Incidence of anastomotic leakage was significantly higher after emergency right hemicolectomy (4.3 percent). Overall morbidity following excision of the rectum was high (40.2 percent). Respiratory and cardiac complications predominated. Incidence of clinically significant anastomotic leakage following anterior resection was low (2.9 percent). Over the years, there has been a decline in the number of patients with tumor demonstrated histologically in a line of resection, suggesting an improved local surgical clearance.
These results following conventional surgery may be useful when evaluating new techniques.
本研究旨在报告接受传统手术治疗的结直肠癌患者术后并发症的发生率及死亡率。
对1846例接受开放性结直肠癌切除术的患者进行了发病率和死亡率分析，这些患者的临床、手术及病理数据在20年期间进行了前瞻性记录。
左半结肠和右半结肠择期切除术后死亡率较低，但总体发病率较高（37.2%）。呼吸和心脏并发症尤为常见。右半结肠切除术（0.5%）和左半结肠切除术（1.1%）后具有临床意义的渗漏发生率相似。急诊右半结肠切除术后吻合口漏发生率显著更高（4.3%）。直肠切除术后总体发病率较高（40.2%）。呼吸和心脏并发症占主导。前切除术临床显著吻合口漏发生率较低（2.9%）。多年来，在切除线上组织学证实有肿瘤的患者数量有所下降，提示局部手术切缘有所改善。
这些传统手术的结果在评估新技术时可能有用。
