Title高龄结肠癌患者接受完整结肠系膜切除术的可行性研究
Other TitlesFeasibility of complete mesocolic excision in elderly patients with colon cancer
Authors高志冬
叶颖江
杨晓东
尹慕军
梁斌
姜可伟
谢启伟
曲军
王有利
申占龙
郭鹏
王杉
Affiliation100044,北京大学人民医院胃肠外科
Keywords结肠肿瘤
完整结肠系膜切除术
高龄
治疗效果
安全性
Colonic neoplasms
Complete mesocolic excision
Elderly
Treatment outcomes
Safety
Issue Date2012
Publisher中华胃肠外科杂志
Citation中华胃肠外科杂志.2012,15,(10),1023-1026.
Abstract目的 探讨高龄结肠癌患者接受完整结肠系膜切除术(CME)的短期疗效和安全性.方法 回顾性分析北京大学人民医院胃肠外科2009年11月至2012年2月间接受CME治疗的71例结肠癌患者的临床资料,以70岁为界点分为高龄组(大于或等于70岁,37例)和非高龄组(小于70岁,34例),比较两组患者的短期疗效和安全性.结果 高龄组与非高龄组结肠癌患者CME手术切除系膜面积分别为(13049±4332) mm2和(13163±4725) mm2,高位结扎血管距肠壁距离为(95±22) mm和(98±20) mm,高位结扎血管距肿瘤距离为(130±25) mm和(128±25) mm,结肠切除长度(262±60) mm和(245±49) mm,淋巴结清扫数目为(22.0±6.4)枚和(24.8±9.9)枚,差异均无统计学意义(均P>0.05).两组患者手术时间、术中出血量、术后主要并发症、排气时间、排粪时间、引流管拔除时间、恢复进食时间、术后3d引流量、住院死亡等安全性指标的差异亦无统计学意义(均P>0.05),但高龄患者住院时间和住院费用明显增加(均P<0.01).结论 高龄结肠癌患者接受择期CME手术可以达到与非高龄组患者一致的肿瘤切除及淋巴结清扫效果,且手术安全性良好.
Objective To explore the short-term outcomes and safety of complete mesocolic excision (CME) in elderly patients with colon cancer.Methods The clinical pathological factors of 71 patients with colon cancer undergoing CME procedure by the same group of surgeons were analyzed retrospectively from November 2009 to February 2012.The elderly group (≥70 years) and the non-elderly group (<70 years) were compared regarding short-term outcomes and safety.Results Similar extent of resection could be achieved in the elderly and non-elderly groups in terms of area of mesentery [(13049±4332) vs.(13163±4725) mm2,P=0.916],distance between the tumor and the high ligation site [(95±22) vs.(98±20) mm,P=0.516],distance between normal bowel and high ligation site [(130±25) vs.(128±25) mm,P=0.731],the length of colon [(262±60) vs.(245±49)mm,P=0.212],and lymph nodes retrieved (22.0±6.4 vs.24.8±9.9,P=0.168).The mean operative time,intraoperative blood loss,postoperative complications,time to first flatus,time to first bowel movement,drainage removal time,diet resumption,drainage volume in three days after surgery,and hospital deaths showed no statistical significances (all P>0.05),while hospital stay and expenses of the elderly group were significantly increased (both P<0.01).Conclusion Elderly patients undergoing elective CME operation can achieve similar operative extent and lymph nodes harvest,and the surgical risk is not increased.
URIhttp://hdl.handle.net/20.500.11897/124997
ISSN1671-0274
DOI10.3760/cma.j.issn.1671-0274.2012.10.011
IndexedPubMed
中国科技核心期刊(ISTIC)
Appears in Collections:人民医院

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