Title腹腔镜辅助胃癌根治术应用于高龄患者的临床疗效
Other TitlesClinical efficacy of laparoscopy-assisted radical gastrectomy in elderly patients with gastric cancer
Authors杨宏
崔明
邢加迪
姚震旦
张成海
张楠
苏向前
Affiliation100142,北京大学肿瘤医院暨北京市肿瘤防治研究所胃肠肿瘤微创外科 恶性肿瘤发病机制及转化研究教育部重点实验室
Keywords胃肿瘤 腹腔镜 胃切除术 高龄 Stomach neoplasms Laparoscopy Gastrectomy Elderly
Issue Date2015
Publisher中华胃肠外科杂志
Citation中华胃肠外科杂志.2015,(1),21-25.
Abstract目的:探讨腹腔镜辅助胃癌根治术应用于高龄患者的临床疗效。方法回顾性分析北京大学肿瘤医院胃肠肿瘤微创外科在2009年5月至2012年12月间行腹腔镜辅助胃癌根治术的214例患者的临床资料,其中年龄大于或等于70岁者53例(高龄组),小于70岁者161例(非高龄组),比较两组患者的手术情况及术后恢复。结果高龄组总体ASA评分比非高龄组差,且合并高血压和糖尿病的患者更多(均P<0.05)。两组平均手术时间、术中失血量、术中输血率、中转开腹率、术后排气时间和术后住院时间比较,差异均无统计学意义(均P>0.05)。高龄组清扫淋巴结数目与非高龄组相比有减少趋势,分别为(26.4±9.7)枚和(30.0±12.4)枚,但两组比较,差异无统计学意义(P>0.05)。高龄组和非高龄组患者术后总体并发症发生率分别为30.2%(16/53)和19.9%(32/161),手术相关并发症发生率分别为18.9%(10/53)和18.0%(29/161),差异均无统计学意义(均P>0.05);但高龄组术后内科系统并发症发生率更高[11.3%(6/53)比1.9%(3/161),P<0.05]。两组术后30 d内死亡率分别为1.9%(1/53)和0.6%(1/161),差异无统计学意义(P>0.05)。结论高龄患者由于合并更多基础疾病,增加了术后内科并发症的风险,但腹腔镜辅助胃癌根治术并不增加高龄患者的手术相关风险。
To investigate the clinical efficacy of laparoscopy-assisted radical gastrectomy in elderly patients with gastric cancer.Clinical data of 214 patients with gastric cancer were analyzed retrospectively, who underwent laparoscopy-assisted radical gastrectomy in the Department of Minimally Invasive Gastrointestinal Surgery at Beijing Cancer Hospital between May 2009 and December 2012. The patients were divided into two groups, consisting of elderly group(age ≥70 years old, n=53) and non-elderly group(age <70 years old, n=161). The operative procedure and postoperative recovery were compared between the two groups.Elderly group had a worse ASA score as compared to non-elderly group with significant difference(P<0.05). Among the elderly, the incidences of concomitant diseases, such as hypertension and diabetes, were significantly higher. No significant differences were observed in terms of duration of operation, blood loss, blood transfusion rate, conversion to laparotomy, time to first flatus and postoperative hospital stay between the two groups(P>0.05). The mean number of retrieved lymph nodes in elderly group was less than that of non-elderly group (26.4±9.7 vs. 30.0±12.4), but whose difference was not significant(P>0.05). There were no significant differences between two groups with respect to postoperative complications (30.2% vs. 19.9%, P>0.05) and surgery-related complications(18.9% vs. 18.0%, P>0.05), but the incidence of medical complications was higher in elderly group (11.3% vs. 1.9%, P<0.05). Furthermore, the perioperative mortality was 1.9% and 0.6% respectively in elderly and non-elderly groups without significant difference(P>0.05).Associated with more concomitant diseases, the elderly had higher risk of medical complications after operation, while laparoscopy-assisted radical gastrectomy does not increase the risk of surgery-related complications in elderly patients.
URIhttp://hdl.handle.net/20.500.11897/188336
ISSN1671-0274
DOI10.3760/cma.j.issn.1671-0274.2015.01.006
IndexedPubMed
中国科技核心期刊(ISTIC)
中国科学引文数据库(CSCD)
Appears in Collections:北京肿瘤医院

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