腹腔镜胃癌根治术在高龄胃癌患者中的应用

Application of Laparoscopic Radical Resection for Gastric Cancer in Elderly Patients

目的探讨腹腔镜下胃癌根治术在高龄胃癌患者(≥70岁)中临床应用的可行性。方法回顾性分析作者所在医院2009-09/2012-09年间行腹腔镜下胃癌根治术的49例高龄胃癌患者(≥70岁)及83例低龄胃癌患者(<70岁),比较两组患者术前临床特点,术后近期恢复情况、并发症及远期生存质量。结果高龄组贲门胃底癌、胃窦癌发生率分别为41.1%、28.3%;低龄组发生率分别为25.3%、44.6%,高龄组贲门胃底癌发生率较高,差异有统计学意义(P<0.05);高龄组患者术中输血率为18.4%,低龄组为8.4%,有统计学差异(P<0.05);高龄组术后并发症率为16.3%,低龄组为13.3%,差异无统计学意义(P>0.05);术后3个月时,高龄组患者发生不适症状6例(12.2%),低龄组患者发生不适症状9例(10.8%),差异无统计学意义(P>0.05)。结论腹腔镜下胃癌根治术在高龄胃癌患者的应用可行、安全。

Objective To evaluate the feasibility of laparoscopic radical resection for gastric cancer in Elderly pa- tients （≥70 years old） in clinical application. Methods A total of 49 elderly patients with gastric cancer （≥70 years old） and 83 younger patients with gastric cancer （〈70 years old） undergoing laparoscopic gastric cancer radical mastectomy between September 2009 and September 2012 were retrospectively analysed. The preoperative clinical characteristics, the recent recovery and complications, and the long-term quality of life of the two groups of patients were compared. Results The incidence of cardiac fundic cancerand distal gastric cancer was 41.1% and 28.3% in the elderly group, 25.3% and 44. 6% in the younger group respectively, which were significantly lower in the elderly group （P〈0. 05）. The intraoper- ative blood transfusion rate was 18. 4% and 8. 4% in the elderly and younger groups respectively （P〈0. 05）. The postop- erative complications rate was 16. 3% and 13. 3% in the elderly and younger groups respectively （P〉0. 05）. At 3 months after surgery, 6 cases （12.2%） in the elderly group and 9 cases （10.8%） in the younger group had uncomfortable symptoms （P〉0.05）. Conclusion The application of laparoscopic gastric cancer radical in elderly patients is feasible and safe.