Peters W R, Fleshman J W
Department of Surgery, Boone Hospital Center, Columbia, MO, USA.
Surg Laparosc Endosc. 1995 Dec;5(6):477-9.
The safety of minimally invasive colectomy (laparoscopic or laparoscopically assisted colectomy) has not been evaluated in the elderly patient. Therefore, a prospective study of the outcome of minimally invasive colectomy (MIC) in patients aged 65 years or older was undertaken. Between October 1991 and September 1993, 103 elderly patients underwent attempted MIC (right colectomy, 53; left colectomy, sigmoid colectomy, or anterior resection, 36; abdominoperineal resection, 12; and total proctocolectomy with ileostomy, 2); 81 procedures were successfully completed. Complications occurred in 23% of patients converted to laparotomy (including one death) and in 25% undergoing successful MIC (two deaths, p = ns). The average length of postoperative stay was 5.3 days in the MIC group and 8.1 days for patients converted to laparotomy (p < 0.001). These results compare favorably with published results of traditional colectomy for elderly patients. We conclude that MIC is safe in the elderly patient and that further studies are warranted.
尚未对老年患者进行微创结肠切除术（腹腔镜或腹腔镜辅助结肠切除术）的安全性进行评估。因此，开展了一项针对65岁及以上患者微创结肠切除术（MIC）结果的前瞻性研究。1991年10月至1993年9月期间，103例老年患者尝试接受MIC（右半结肠切除术53例；左半结肠切除术、乙状结肠切除术或前切除术36例；腹会阴联合切除术12例；全直肠结肠切除术加回肠造口术2例）；81例手术成功完成。转为开腹手术的患者中有23%发生并发症（包括1例死亡），成功接受MIC的患者中有25%发生并发症（2例死亡，p =无显著性差异）。MIC组术后平均住院时间为5.3天，转为开腹手术的患者为8.1天（p < 0.001）。这些结果优于已发表的老年患者传统结肠切除术的结果。我们得出结论，MIC对老年患者是安全的，值得进一步研究。
