中青年和老年结肠癌患者行腹腔镜下根治术的疗效差异比较

Curative effect of young-middle-aged and elderly patients with colon cancer underwent laparoscopic surgery

目的探索中青年和老年结肠癌患者行腹腔镜下根治术的疗效。方法选取2012年1月至2014年2月中青年和老年结肠癌确诊患者各60例,分为中青年组和老年组,进行腹腔镜下根治术,其中中青年组患者中28例进行左半结肠切除术,32例进行右半结肠切除术;老年组患者中24例行左半结肠切除术,36例行右半结肠切除术,采用SPSS 18.0版统计学软件进行分析,术中术后相关指标以均数±标准差表示,组间比较采用t检验;术后并发症发生率采用χ~2检验;以P<0.05表示差异具有统计学意义。结果中青年组和老年组患者进行左半切结肠切除术的并发症发生率分别为7.1%(2/28)、8.3%(2/24),P>0.05;两组患者随访2年的复发率、近端转移率差异无统计学意义;右半切除术的并发症发生率分别为15.6%(5/32)、33.3%(12/36),差异有显著统计学意义(P<0.05),结果表明中青年组右半结肠切除术患者术后并发症发生率明显低于老年组。结论不同年龄段结肠癌患者进行右半结肠切除术的术后并发症发生率均明显高于左半结肠切除术,但中青年患者术后并发症发生率明显低于老年患者。

Objective To explore the curative effect of laparoscopic radical resection of colon cancer for young-middle-aged and elderly patients. Methods From January 2012 to February 2014,young-middle-aged and elderly-aged patients with colon cancer underwent laparoscopic colectomy were enrolled and 60 cases were divided into each groups. 28 patients in young-middle-aged group received left hemicolectomy and 32 cases underwent right hemicolectomy; 24 cases in Elderly group received left hemicolectomy,and 36 cases underwent right hemicolectomy. Statistical analysis were performed by using SPSS 18. 0 software,intraoperative related indicators and the postoperative indicators were presented as（x± s） and were examined by using t test; Count data was examined by using chi square test. P〈0. 05 was considered as significant difference. Results The complication rates of patients received left hemicolectomy in the young-middle-aged group and elderly group were 7. 1%（2/28） and 8. 3%（2/24）,with no significant difference between 2 group P〈0. 05. There was no significant difference in terms of 2 years recurrence rate and proximal metastasis rate within follow-up period between two groups. The complication rates of two groups underwent right-laparoscopic surgery were 15. 6%（5/32） and 33. 3%（12/36） respectively,with significant difference P〉0. 05. There was no significant difference of the incidence of postoperative complications between 2 groups received left hemicolectomy. However, the postoperative complication rates of young-middle-aged group received right hemicolectomy was significantly lower than that of elderly group. Conclusion The incidence of postoperative complications of different aged patients underwent right hemicolectomy is significantly higher than left-hemicolectomy,and complication rate of young-middle-aged patients is significantly lower than that of elderly patients.