双镜联合与开腹手术治疗老年人结直肠癌的对比研究

Comparative study of double microscopy combined with open surgery in treatment of elderly colorectal cancer

目的探讨双镜（腹腔镜与结肠镜）联合结直肠癌根治术在老年人结直肠癌中应用的可行性及临床疗效。方法将2011年1月-2013年12月间我院普外科收治的62例结直肠癌患者随机分为观察组31例和对照组31例,观察组应用双镜（腹腔镜与结肠镜）联合,对照组应用传统开腹结直肠癌根治术,比较两组的首次肛门排气时间、术后住院天数、手术时间、手术中出血量、清扫淋巴结数目、术后并发症发生率。结果与对照组相比,观察组术后并发症发生率降低,首次排气时间提前,住院时间缩短,差异有统计学意义（P〈0.05）。两组患者清扫淋巴结数目无明显差异。双镜（腹腔镜与结肠镜）联合组术中出血量明显少于开腹组,手术时间明显长于开腹组。结论双镜（腹腔镜与结肠镜）联合治疗老年结直肠癌是安全可行的。

Objective To investigate the application feasibility and clinical efficacy ofdouble microscopy（laparoscopy and colonoscopy） combined with colorectal cancer radical operationin the treatment of elderlycolorectal cancer. Methods A total of 62 patients with colorectal cancer treated in department of general surgery in our hospital from January 2011 to December 2013, were randomly divided into the observation group and the control group, each group with 31 cases.The observation group received double microscopy（ laparoscopy and colonoscopy） surgery, and the control groupreceived conventional open colorectal cancer radical operation. Anal exhaust timefor the first time, postoperative hospital stay, operative time, operative blood loss, number of lymph node dissection, postoperative complications rate were compared. Results Compared with the control group, the incidence of postoperative complications in the observation group reduced, anal exhaust timefor the first time advanced, hospital stay was shorter, and the differences were statistically significant（P〈0.05）. There was no significant difference in the number of lymph node dissectionof patients in the two groups. Operative blood lossin the double microscopy（laparoscopy and colonoscopy） combination group was significantly less than that in the open surgery group, and operative time in the double microscopy（laparoscopy and colonoscopy）combination group was significantly longer than that in the open surgery group. Conclusion Double microscopy（laparoscopy and colonoscopy） combination treatment in elderly colorectal cancer is safe and feasible.