老年人改良衰弱指数与新辅助治疗后行腹腔镜直肠癌患者围手术期并发症的相关性分析

The analysis of correlation between modified frailty index and postoperative complications of aged patient with Laparoscopic rectal cancer surgery with neoadjuvant therapy

目的评估改良衰弱指数(mFI)在预测新辅助治疗后行腹腔镜直肠癌手术老年患者短期疗效及肿瘤学结果中的应用。方法收集广州市第一人民医院2012年1月至2018年6月行新辅助治疗后再行腹腔镜直肠癌手术的老年患者147例,依据患者术前mFI评分分为无衰弱组(mFI≤0.29,106例)、衰弱组(mFI>0.29,41例),并对两组患者在人口统计学、手术相关数据、短期临床疗效、术后并发症等指标进行统计分析。结果27.9%的患者被评估为衰弱。衰弱组患者在住院天数、术后并发症均高于非衰弱组患者(13.7±8.6 vs 10.5±3.8 d,P=0.025;20/106 vs 16/14例,P=0.011)。结论mFI过高是预测新辅助治疗后行直肠癌患者术后并发症发生的重要指标,术前对老年结直肠癌患者患者进行mFI评分有助于为临床诊疗提供合理依据,降低术后并发症发生率。

Objective To evaluate the application of modified frailty index(mFI)in predictingshort-term outcomes of elderly patients undergoing laparoscopic rectal cancer surgery after neoadjuvanttherapy.Methods We collected 147 elderly patients who underwent laparoscopic rectal cancer surgeryafter neoadjuvant therapy in Guangzhou First People′s Hospital from January 2012 to June 2018.Accord.ing to the preoperative mFI score,they were divided into non-weakening group(mFI<0.29,106 cases)and weakening group(mFI>0.29,41 cases).The demographic data,operation-related data,shorttermclinical efficacy and postoperative complications of the two groups were analyzed.Statistical analysiswas carried out on the indicators.Results 27.9%of patients were assessed as weak.There were significantdifferences in hospitalization days,post-operative complications between the weakened group and thenon-weakened group(13.7±8.6 vs 10.5±3.8 d,P=0.025;20/106 vs 16/14,P=0.011).ConclusionExcessive mFI is an important index to predict the occurrence of complications after neoadjuvant therapyfor rectal cancer patients.Preoperative mFI score for elderly patients with colorectal cancer is helpful toprovide a reasonable basis for clinical diagnosis and treatment and reduce the incidence of complicationsafter surgery.