70岁以上高龄结直肠癌患者的手术治疗

Surgical treatment of colorectal carcinoma in elderly patients over 70 years of age

目的研究70岁以上结直肠癌患者根治性手术治疗的效果。方法回顾分析1992年3月至2002年3月期间,在我院接受根治性手术治疗的70岁以上结直肠癌患者121例(Ⅰ组)的临床资料,并与同期小于70岁、但在60岁以上的478患者(Ⅱ组)的手术情况进行比较。结果两组手术时间、出血量相比,差异无显著性意义(P>0.05)。Ⅰ组较Ⅱ组输血量多、住院时间长,两组比较,差异有显著性意义(P<0.0001,P=0.0106)。并发症的发生率Ⅰ组为29.8%,Ⅱ组为21.3%,两组比较差异有显著性意义(χ2=3.855,P=0.0496)。术后平均生存时间Ⅰ组(48.0±2.0)个月,Ⅱ组(48.0±1.9)个月;两组5年生存率比较,差异无显著性意义(P=0.6816)。结论对70岁以上的高龄老年结直肠癌患者施行根治性手术后有较高的生存率,应对其积极地采取根治手术治疗。

Objective To assess the outcomes of surgical treatment for colorectal carcinoma in the elderly patients over 70 years of age. Methods Clinical data of 599 colorectal carcinoma patients over 60 years of age treated by radical resection from March,1992 to March, 2002 were analyzed retrospectively. The surgical outcomes were compared between the patients over 70 years and within 60 to 69 years. Results There were 121 patients over 70 years(groupⅠ), and 478 patients with an age from 60 to 69 years(groupⅡ). There was no significance in operative time,blood loss between the two groups. The transfusion volume was more(P< 0.0001) and hospital stay was longer(P=0.0106) in groupⅠthan those in groupⅡ. The postoperative morbidity rate was 21.3%in groupⅡand 29.8%in groupⅠrespectively, and there was significant difference(P=0.0496). The mean survival time was (48.0±2.0) months in groupⅠand (48.0±1.9) months in groupⅡ, and there was no significant difference in 5 year survival between the two groups. Conclusion Radical resection is a safe treatment for elderly patients with colorectal carcinoma, and survival rate is acceptable.