腔镜与开腹手术治疗老年结直肠癌手术效果及术后并发症

摘要

Objective:To evaluate the safety and feasibility of laparoscopy in treatment of colorectal cancer pa-tients in elderly.Methods:A total of 100 patients were randomly divided into 2 groups,the laparoscopic resection(n=50)group and the open radical resection(n =50).Operation time,blood loss,ambulation time,number of lymph nodes dissection,defecation,first liquid time,hospital costs,length of incision,exhaust time,hospital stay and opera-tive complications were analyzed.Results:No significant differences were found in operation time,blood loss,ambula-tion time,number of lymph nodes dissection,defecation,first liquid time ,hospital costs between two groups(all P>0.05).But,Incision length,exhaust time,and hospital stay in the laparoscopic resection were shorter than the open radical resection(P <0.05).However,the indications of postoperative complication was 44%(22 /50)in the laparo-scopic resection the open radical resection group 70%(35 /50),statistically significant difference was found between the two groups(P <0.05).Conclusion:Laparoscopic is safe,less postoperative complication and feasible in the treat-ment of colorectal cancer in the elderly.%目的：评估70岁以上老年结直肠癌腹腔镜手术外科治疗的安全性、可行性。方法：回顾100例结直肠癌患者，根据手术方式分为腔镜手术（n ＝50）和开腹手术（n ＝50）。比较患者手术时间、术中出血量、术后下床时间、清扫淋巴结数目、排便时间、首次流质时间、住院费用、切口长度、排气时间、住院时间及术后并发症等指标。结果：两组患者的手术时间、术中出血量、术后下床时间、清扫淋巴结数目、排便时间、首次流质时间以及住院费用无显著差别（P ＞0．05），切口长度、排气时间以及住院时间，腹腔镜组优于开腹组（P ＜0．05）。各组术后并发症发生率分别为腹腔镜组44％（22／50），开腹组70％（35／50），腔镜组患者出现并发症的患者显著少于开腹组（P ＜0．05）。结论：腹腔镜手术对于老年结直肠癌是安全的，根治性的，术后并发症较少，是老年结直肠癌外科治疗的可靠手术方式。