两种直肠癌根治术治疗不同年龄直肠癌患者的疗效分析

Therapeutic effect of two radical surgery for rectal cancer in patients of different age

目的探讨腹腔镜直肠癌根治术和直肠癌常规开腹根治性手术治疗不同年龄段直肠癌患者的疗效。方法将200例直肠癌患者,根据年龄和手术方式的不同分为高龄(≥80岁)腹腔镜组(n=30)、高龄开腹组(n=30)、老年(≥60岁,且﹤80岁)腹腔镜组(n=34)、老年开腹组(n=32)、中年(≥40岁,且﹤60岁)腹腔镜组(n=38)、中年开腹组(n=36)。比较不同组别患者的术中、术后相关指标及不良反应发生情况。结果不同年龄段腹腔镜组患者的手术时间、术后排气时间、术后进食时间、术后住院时间均短于相同年龄段开腹组患者,术中出血量、创口大小均小于相同年龄段开腹组患者,差异均有统计学意义(P﹤0.05)。中年腹腔镜组患者的手术时间短于老年腹腔镜组和高龄腹腔镜组患者,术后进食时间短于高龄腹腔镜组患者,差异均有统计学意义(P﹤0.05);中年开腹组患者的手术时间短于老年开腹组和高龄开腹组患者,术后排气时间、术后进食时间均短于高龄开腹组患者,差异均有统计学意义(P﹤0.05)。腹腔镜组与开腹组患者的并发症发生情况比较,差异无统计学意义(P﹥0.05)。结论腹腔镜直肠癌根治术治疗不同年龄段直肠癌患者的疗效相当,且与开腹手术比较,腹腔镜手术有着明显的优势,值得临床广泛应用。

Objective To investigate the curative effect of laparoscopic radical resection for rectal cancer and routine laparotomy in rectal cancer patients of different age. Method According to age distribution and different surgical procedures, 200 patients with rectal cancer were stratified as elderly (≥80 years old) laparoscopic surgery group (n=30), elderly laparotomy group (n=30), senior (≥60, and <80 years old) laparoscopic surgery group (n=34), senior laparotomy group (n=32), middle-aged (≥40 years old, and <60 years old) laparoscopic surgery group (n=38), and middle-aged laparotomy group (n=36). The intraoperative and postoperative indicators, and adverse reactions of these groups were compared. Result In all age groups, patients administered with laparoscopic surgery had significantly shorter operative time, postoperative anal exhaust time, postoperative feeding time, postoperative hospital stay, and lesser intraoperative blood loss, wound size compared with those treated with laparotomy. The operative time of the middle- aged laparoscopic surgery group was shorter than that of the elderly laparoscopic surgery group and senior laparotomy group, the postoperative feeding time of the middle-aged laparoscopic surgery group was less than that of the elderly laparoscopic surgery group, and the differences were of statistical significance (P<0.05);the middle-aged laparoscopic surgery group had shorter operative time than senior laparotomy and elderly laparotomy group, the postoperative anal exhaust time and postoperative feeding time of the middle-aged laparotomy group were decreased compared with the elderly laparotomy group (P<0.05). There was no significant difference regarding the incidence of complications between the laparoscopic surgery group and laparotomy group (P>0.05). Conclusion Laparoscopic radical resection is consistently effective for rectal cancer patients of different age, compared with laparotomy, laparoscopic surgery is obviously advantageous and is worthy of clinical application.