摘要
目的探讨腹腔镜手术与开放手术在75岁以上直肠癌患者中的应用效果。方法回顾性分析2014年6月至2016年6月本院收治的63例75岁以上直肠癌患者临床资料,根据手术方式的不同分为A组(n=33)和B组(n=30),A组患者行腹腔镜手术,B组患者行开放手术,对比两组患者的手术相关指标、手术前后的CRP(C反应蛋白)、白细胞计数(WBC)、免疫指标及并发症发生情况。结果 A组手术时间、术后住院时间、胃肠功能恢复时间均显著短于B组,术中出血量显著少于B组,差异均有统计学意义(均P<0.05)。两组淋巴结清扫数目差异无统计学意义(P>0.05)。与术前1 d相比,B组术后3 d的WBC、CRP、IL-6明显升高,淋巴细胞总数明显降低(均P<0.05);A组术后3 d的WBC、CRP、IL-6水平均显著低于B组,淋巴细胞总数水平显著高于B组(均P<0.05)。A组术后并发症总发生率为3.03%,显著低于B组的13.33%,差异有统计学意义(P<0.05)。结论与开放手术相比,腹腔镜手术应用于75岁以上直肠癌患者疗效确切,术后并发症发生率低且利于术后恢复。
Objective To investigate the effect of laparoscopic surgery and open surgery on rectal cancer patients over 75 years old.Methods 63 patients over 75 years with colorectal cancer in patients were admitted to our hospital and divided into group A（n = 33）and group B（n = 30）,group A and group B were treated with laparoscopic surgery and open surgery,respectively. The changes of operative time,postoperative the hospitalization time,bleeding volume,postoperative complications,gastrointestinal function recovery time,tumor radical index,lymph node clearance index and immune index were compared before and after operation.Results The operation time,postoperative hospital stay and the recovery time of gastrointestinal function in group A were significantly shorter than those in group B,meanwhile,the amount of bleeding during operation was significantly lesser than that in group B（P〈0. 05）. There was no significant difference in the number of lymph node dissection between the two groups and the margin of tumor resection（P〈0. 05）. The amount of WBC,CRP and IL-6 in the third day increased significantly after operation in group B,compared with the first day,lymphocytes decreased significantly（P〈0. 05）. The WBC,CRP,IL-6 of the third day in group A were significantly lower than those of B group,lymphocyte level significantly in group B（ P〈0. 05）. The incidence of postoperative complications in group A was3.03%,significantly lower than that in group B,13.33%,（P〈0. 05）. Conclusion Compared with open surgery,the effect of laparoscopic surgery in the treatment of elderly patients with rectal cancer is curative with less complications,faster postoperative recovery,which is an ideal surgical method for elderly colorectal cancer.
作者
李海旭
Li Haixu.(Department of Anorectal Surgery,The First People＇s Hospital of Longnan,Longnan,Gansu,746000,Chin)
出处
《结直肠肛门外科》
2017年第3期288-291,共4页
Journal of Colorectal & Anal Surgery
关键词
直肠癌
老年患者
腹腔镜
开放手术
rectal cancer
gerontal patient
laparoscopy
open surgery
