摘要
目的分析腹腔镜手术在高龄结直肠癌患者中的安全性和适用性。方法以2012年4月—2014年6月在绵阳市肛肠病医院进行手术治疗的高龄结直肠癌207例为研究对象,其中89例为传统手术切除肿瘤(传统手术组),118例采用腹腔镜手术切除肿瘤(腹腔镜手术组),对比两组术中手术指标、恢复指标、术后并发症和预后方面的差异。结果腹腔镜手术组手术用时较传统组稍长,但差异无统计学意义(P>0.05),腹腔镜手术组术中出血量明显少于传统手术组(P<0.05),两组在淋巴结清扫个数上的差异无统计学意义(P>0.05)。腹腔镜手术组在术后肛门排气时间、下床时间、进食流质时间和住院时间方面均短于传统手术组(P<0.05)。腹腔镜手术组手术并发症总发生率明显低于传统手术组(P<0.05),两组在住院期间的病死率相当(P>0.05)。两组在术后1、3年的生存率、复发率和远处转移率差异均无统计学意义(P>0.05)。结论对于高龄结直肠癌的手术切除术,腹腔镜具有术中创伤小、术后恢复快和并发症少的优势,预后和传统手术组相当。
Objective To analyze safety and applicability of laparoscopic surgery in treatment of elderly patients with colorectal cancer. Methods A total of 207 elderly colorectal cancer patients with traditional surgical ablation（ group A） and 118 elderly colorectal cancer patients with laparoscopic surgical ablation（ group B） admitted during April2012 and June 2014 were recruited in this study. Differences in intraoperative indexes,postoperative recovery indexes,postoperative complications and prognosis were compared in two groups. Results Operative time in group B was longer than that in group A,but the difference was not statistically significant（ P〈0. 05）. Intraoperative bleeding volume in group B was significantly less than that in group A（ P〈0. 05）. There was no statistical difference in number of lymph node dissection between two groups（ P〉0. 05）. Postoperative time of anal exhaust,ambulation time,eating fluid time and hospital stay in group B were shorter than those in group A,and the differences were statistically significant（ P〈0. 05）. The total incidence rate of complications in group B was significantly lower than that in group A（ P〈0. 05）. The two groups had similar fatality rate during hospitalization,but the difference was not statistically significant（ P〉0. 05）.There were no significant differences in survival,recurrence and distant metastasis rates in 1 year and 3 years after operation between two groups（ P〉0. 05）. Conclusion Laparoscopic surgical ablation in treatment of elderly patients with colorectal cancer has advantages of mini intraoperative trauma,rapidly postoperative recovery and low incidence rate of complications,and it is comparable to the traditional group in prognosis.
作者
杨明川
雷绍斌
幸代园
王建
许海平
潘勇
YANG Ming-chuan;LEI Shao-bin;XING Dai-yuan;WANG Jian;XU Hai-ping;PAN Yong(Department of Colorectal Surgery,Anorectal Disease Hospital of Mianyang,Mianyang,Sichuan 621000,China;Department of Gas- trointestinal Surgery,Sichuan Provincial People＇s Hospital,Chengdu 610041,China)
出处
《解放军医药杂志》
CAS
2018年第5期19-21,29,共4页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基金
四川省卫生和计划生育委员会科研课题(150217)
