腹腔镜手术对老年结直肠癌患者安全性及效果的Meta分析

Meta-analysis of laparoscopic for elderly patients with colorectal cancer

目的系统评价腹腔镜手术对老年结直肠癌患者的安全性和效果。方法以 laparoscopic laparoscopic colectomy＂ ＂colorectal cancer ＂rectal cancer octogenarian＂ ＂elderly＂为检索词，检索Pubmed、WebofSicence和Embase数据库中2000年1月一2017年5月发表的腹腔镜与开腹手术治疗高龄结直肠癌患者的临床研究，提取数据后采用Statal2．0软件对手术指标、术后并发症及远期疗效进行Meta分析。结果共纳入18项研究，共计3162例患者，Meta分析结果显示，腹腔镜组手术时间长于开腹组（P〈0．001），但术中出血量、术后切口感染、肠梗阻、心血管意外发病率均低于开腹组（均P〈0．05）；两组在淋巴结清扫数目、吻合口瘘、肺炎发病率和总生存率和无瘤生存率方面差异无统计学意义（P〉0．05）。结论腹腔镜手术对高龄结直肠癌患者可取得与开腹手术相同的远期疗效，且术后恢复快，并发症发病率低，安全可靠。

Objective To evaluate and compare the efficacy and safety of laparoscopic surgery in the treatment of elder eolorectal cancer patients. Methods Selected the retrospective or prospective studies which were retrieved in Pubmed, web of Science, Embase as laparoscopic, laparoscopic coleetomy, eolorectal cancer, rectal cancer, octogenarian, elderly published between Jan. 2000 and May 2017. Data regarding operative indexes, postoperative complications and long term outcomes were analyzed by Statal2.0 software. Results A total of 18 articles, included 3 162 patients, were enrolled in this study. The Meta-analysis indicated that there were no significant differences of less blood loss, postoperative wound infection, bowel obstruction and cardiovascular complications in laparoscopic surgery group except the operative time （P 〈 0.05）. No significant difference was found in the number of dissected lymph node, pneumonia, overall survival and disease free survival （ P 〉 0.05 ）. Conclusion With advantages of rapid postoperative recovery and fewer complications, laparoseopic radical resection for eolorectal cancer in elderly patients is safe and effective.