163例高龄结直肠癌合并糖尿病患者的围手术处理体会

Surgical treatment of colorectal cancer in elderly patients associated with diabetes mellitus

目的探讨高龄结直肠癌合并糖尿病患者的围手术处理。方法对1994～2004年围手术处理的163例高龄(年龄大于60岁)结直肠癌合并糖尿病患者作回顾性分析。结果163例病人均作结直肠癌择期手术,术后并发症发生率39.9%,其中切口感染19.6%(32/163),肺部感染12.3%(20/163),吻合口漏占3.7%(6/163),泌尿系感染为2.5%(4/163),高渗性昏迷1.2%(2/163),死亡0.6%(1/163)。术后平均住院20天。结论如能做到控制血糖、选择合理的术式和手术时机,高龄结直肠癌并糖尿病患者可顺利度过围手术期,并取得良好的手术疗效。

Objective To study the method of surgical treatment of colorectal cancer in elderly patients associated with diabetes mellitus. Methods From 1994 to 2004, 163 elderly patients with eoloreetal cancer associated with diabetes mellitus received operations were analyzed retrospectively.Results 163 eases underwent elective operations. The Morbidity of postoperative complications：wound infection was in 32 eases （19.6%）, pneumonia 12 eases （12.3%）, and anastomotie leakage 6 eases （3.7%）, and urinary tract infection 4 eases （2.5%）, and hyper osmotic coma 2 eases （1.2%）, 1 eases died, the mortality was 0.6%. Average hospitalization was 20 days after operation. Conclusion If strictly control the blood sugar,selective reasonable surgical procedure and operative timing can be performed, the perioperative period can be passed unevenfully and a satisfactory operative efficacy can be obtained for elderly patients with colorectal cancer associated with diabetes mellitus.