老年结直肠癌腹腔镜辅助与开腹根治术的近期和远期疗效比较

The comparison of short-term and long-term therapeutic effect of laparoscopic-assisted surgery versus open surgery for the elderly patients with colorectal cancer

目的比较老年结直肠癌腹腔镜辅助与开腹根治术的近期和远期疗效。方法回顾性分析2013年1月至2015年1月58例年龄≥70岁老年结直肠癌患者的临床资料,根据手术方式分为腹腔镜组(27例)和开腹组(31例),采用SPSS20. 0软件进行统计学分析,围手术期相关指标等以(x珋±s)表示,独立样本t检验;术后并发症发生率、局部复发率、远处转移率和累积生存率等组间比较采用χ2检验,生存率比较用Kaplan-Meier检验,均以P <0. 05为差异有统计学意义。结果两组患者手术时间、淋巴结清扫数目比较,差异均无统计学意义(P> 0. 05)。腹腔镜组术中出血量、VSA评分、术后首次通气时间、恢复饮食时间以及平均住院时间均明显优于开腹组(P <0. 05);两组患者术后并发症发生率、局部复发率、远处转移率和累积生存率比较,差异均无统计学意义(P> 0. 05)。结论腹腔镜辅助治疗老年结直肠癌是安全可行的,值得在临床中进一步推广应用。

Objective To compare the short-term and long-term therapeutic effect of laparoscopic-assisted surgery versus open surgery for the elderly patients with colorectal cancer. Methods From January 2013 to January 2015,a retrospective analysis was performed in 58 elderly patients(aged≥70)with colorectal cancer,including 27 cases in laparoscopy group and 31 cases in laparotomy group.Statistical analysis were performed by using SPSS20.0 software,perioperative related indicators were expressed as mean±standard deviation and were examined by using t test.Post-operative complication rate,local recurrence rate,distal metastasis rate and accumulative survival rate were examined by using Chi-square test.The survival rate was examined by using Kaplan-Meier test.A P<0.05 was considered as statistically significant difference. Results There were no significant differences between the two groups in terms of operation time and number of lymph nodes(P>0.05).The intraoperative blood loss,VAS score,first flatus time,diet recovery time and the average hospitalization time in laparoscopy group were significantly better than those in the laparotomy group(P<0.05),there were no significant differences between the two groups in terms of post-operative complication rate,local recurrence rate,distal metastasis rate and accumulative survival rate(P>0.05). Conclusion Laparoscopic-assisted surgery in treating the elderly patients with colorectal cancer is feasible and safe,which is valuable to be applied in clinic.