腹腔镜结直肠癌根治手术在老年患者中的临床研究

Comparative study of laparoscopic and open colorectal surgery in elderly patients

目的探讨老年患者施行腹腔镜结直肠癌根治手术的安全性及可行性。方法对本院2010年10月至2014年4月之间436例65岁以上的老年患者施行结直肠癌根治术,其中295例接受腹腔镜结直肠癌根治术(腹腔镜组),141例接受开腹手术(开腹组),分析比较两组患者围手术期指标及并发症。结果腹腔镜组术后总的并发症发生率为20.3%(60/295),而开腹组为39.7%(56/141),腹腔镜组明显低于开腹组(P<0.001)。腹腔镜组手术时间(200.52±51.13)分钟,长于开腹组(180.05±57.29)分钟,差异无统计学意义(P=0.268)。术中出血量、平均肛门排气时间、恢复进食时间和平均住院时间方面,腹腔镜组显著优于开腹组。两组均无围手术期死亡病例。结论腹腔镜结直肠癌根治术应用于老年病人安全、可行。

Objective To evaluate the safety and feasibility of laparoscopic colorectal surgery in elderly patients. Methods From October 2010 to April 2014, 436 patients over 65 years underwent radical colorectal surgery in our hospital. All patients were divided into laparoscopic group(n=295) and open group(n=141)..The clinicopathological and peri-operative parameters,.complications were compared retrospectively.Results The overall complication rate was 20.3% in the laparoscopic group, significantly lower than 39.7%in the open group..The mean operation time in the laparoscopic group was(200.52 ±51.13)min,a little longer than(180.05 ±57.29)min in the open group, but there was no significant difference between the two groups(P >0.05). Significantly less intra-operative blood loss, shorter post-operative anal exhaust time and time to early diet, and shorter hospital stay were observed in the laparoscopic group than those in the open group(P <0.05). No perioperative death was found in the two groups. Conclusion Laparoscopic colorectal surgery is safe and feasible in elderly patients.