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中华普外科手术学杂志(电子版) ›› 2019, Vol. 13 ›› Issue (01) : 96 -98. doi: 10.3877/cma.j.issn.1674-3946.2019.01.030

所属专题: 文献

论著

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
邵志伟1, 王锋2,(), 黄其根1   
  1. 1. 210046 江苏南京市栖霞区医院普外科
    2. 210029 南京医科大学第一附属医院(江苏省人民医院) 普外科
  • 收稿日期:2018-03-28 出版日期:2019-02-26
  • 通信作者: 王锋

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

Zhiwei Shao1, Feng Wang2,(), Qigen Huang1   

  1. 1. Department of General Surgery, Qixia Hospital of Nanjing, Nanjing Jiangsu 210046, China
    2. Department of General Surgery, The First Affiliated Hospital with Nanjing Medical University (Jiangsu Province Hospital), Nanjing Jiangsu 210029, China
  • Received:2018-03-28 Published:2019-02-26
  • Corresponding author: Feng Wang
  • About author:
    Corresponding author: Wang Feng, Email:
引用本文:

邵志伟, 王锋, 黄其根. 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[J/OL]. 中华普外科手术学杂志(电子版), 2019, 13(01): 96-98.

Zhiwei Shao, Feng Wang, Qigen Huang. The comparison of short-term and long-term therapeutic effect of laparoscopic-assisted surgery versus open surgery for the elderly patients with colorectal cancer[J/OL]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2019, 13(01): 96-98.

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(±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.

表1 58例老年结直肠癌患者不同术式两组患者临床基线资料比较(例)
表2 58例老年结直肠癌患者不同术式两组患者围术期相关情况比较(±s)
图1 58例老年结直肠癌患者不同术式两组患者生存曲线图
[1]
Aran V,Victorino AP,Thuler LC,et al.Colorectal Cancer: Epidemiology, disease mechanisms and interventions to reduce onset and mortality[J].Clin Colorectal Cancer,2016,15(3):195-203.
[2]
Bouvier AM,Launoy G.Epidemiology of colorectal cancer[J].Rev Prat,2015,65(6):767-773.
[3]
许庆文,徐飞鹏,王妃凤,等.腹腔镜辅助与开腹结直肠癌根治术临床对比研究[J/CD].中华普外科手术学杂志:电子版,2016,10(2):112-115.
[4]
王国森,周建平,盛伟伟,等.手辅助腹腔镜、腹腔镜辅助和开腹结直肠癌手术近期疗效的比较[J].中国医科大学学报,2017,46(2):126-130,135.
[5]
韩越俊,王建平,王庆华,等.老年患者腹腔镜辅助结直肠癌切除术的临床疗效[J].中国普通外科杂志,2017,26(4):463-467.
[6]
何金杰丁克峰.腹腔镜结直肠癌手术的质量控制[J].中华胃肠外科杂志,2015,18(8):759-762.
[7]
迟岳峰.腹腔镜结直肠癌根治与传统根治手术疗效的临床效果对比分析[J/CD].中华普外科手术学杂志:电子版,2016,10(2):130-132.
[8]
徐飞鹏,许庆文,鲁珏,等.腹腔镜辅助与开腹结直肠癌根治术治疗Ⅱ、Ⅲ期结直肠癌效果比较[J].中华实验外科杂志,2015,32(9):2253-2254.
[9]
Wang JH,Kung YH,King TM,et al.Comparison of laparoscopic versus open surgery in a three-stage operation for obstructive left-sided colorectal cancer[J].J Chin Med Assoc,2015,78(10):584-590.
[10]
Kim JW,Park JW,Park SC,et al.Clinical outcomes of laparoscopic versus open surgery for primary tumor resection in patients with stage IV colorectal cancer with unresectable metastasis[J].Surg Today,2015,45(6):752-758.
[11]
Moug SJ,McCarthy K,Coode-Bate J,et al.Laparoscopic versus open surgery for colorectal cancer in the older person: A systematic review[J].Ann Med Surg (Lond),2015,4(3):311-318.
[12]
黄勇,朱宣进,刘建伟.腹腔镜手术治疗老年结直肠癌患者的安全性[J].实用医学杂志,2015,31(4):556-558.
[13]
周德全,徐亮.腹腔镜与开腹结直肠癌切除术远期生存率和并发症的Meta分析[J].实用医学杂志,2016,32(2):291-294.
[14]
阮利斌,何斌.腹腔镜结直肠癌根治术的临床疗效及对患者胃肠功能的影响[J].腹腔镜外科杂志,2016,21(8):601-603.
[15]
刘洪.腹腔镜结肠癌切除联合完整结肠系膜切除在老年结肠癌手术中的应用[J].中国老年学,2017,37(1):115-117.
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