70岁以上老年患者腹腔镜胃癌手术安全性的研究  

Clinical safety and feasibility of laparoscopic radical gastrectomy(surgery) for elderly patients aged over 70 years with gastric cancer

作　　者：孙华朋[1] 张娜[1] 廖晓锋[1] 

机构地区：[1]湖北文理学院附属襄阳市中心医院普外科,湖北襄阳441021

出　　处：《中国内镜杂志》2013年第12期1279-1282,共4页China Journal of Endoscopy

摘　　要：目的探讨70岁以上老年胃癌患者行腹腔镜手术的安全性及可行性。方法回顾总结该院2008年12月~2011年12月收治老年胃癌患者行腹腔镜手术与传统开腹手术的临床资料,同期比较29例腹腔镜手术（腹腔镜组）与44例开腹手术（开腹组）患者的一般情况、疾病分类、ASA手术危险程度分级、术中指标、术后恢复、术后并发症。结果腹腔镜与开腹手术组病例在年龄、性别、疾病分类、术前合并症、ASA手术危险程度分级上均无显著性差异。两组结果显示腹腔镜组术中失血量、切口长度、术后住院时间具有明显优势,其差异与开腹手术组比较差异有显著性（P〈0.05）;腹腔镜组与开腹组在手术时间、切缘阴性率、术中淋巴结清扫范围及个数、肛门排气时间、进食时间上差异无显著性（P〉0.05）。术后并发症对比腹腔镜组和开腹手术组无手术相关死亡;切口感染发生率比较,腹腔镜组明显优于开腹组（P〈0.05）。但在总的并发症发生率比较,腹腔镜组为8例（24.14%）,开腹组11例（25.00%）,差异无显著性（P〉0.05）。结论腹腔镜胃癌根治术具有微创的优点,对于70岁以上老年胃癌患者是安全可行的,其并发症发生率低,是治疗老年人胃癌较好的选择方法。【Objective】To evaluate the safety and feasibility of laparoscopic radical gastrectomy for patients aged over 70 years with gastric cancer. 【Methods】Clinical data of 29 elderly gastric cancer patients undergoing laparoscopic radical gastrectomy surgery（laparoscopic group） and 44 such patients undergoing conventional open surgery（open group） from December 2008 to December 2011 were analyzed retrospectively. Demographic pre-operative coexistent diseases and ASA grade, intrao-perative blood loss, operating time, post-operative recovery and complications were compared between the two groups. 【Results】 No significant differences in age, sex, pre-operative coexistent diseases and ASA grade were found between the laparoscopic group and the open group. There were significant differences in volume of blood loss, hospital stay and length of wound between the two groups（P 0.05）, and the results of laparoscopic group were advantage to patients. There were no significant differences in operation time, no cancer cell of incision margin, the number of lymph nodes, recovery of bowel function and taking in liquid food between the two groups（P 0.05）. No operation-related death occurred in both groups. Wound infection in the laparoscopic group was significantly lower than in the open group（P 0.05）. But there was no significant difference in post-operative complication between the laparoscopic group（24.14%） and the open group（25.00%）（P 0.05）. 【Conclusions】Laparoscopic radical gastrectomy is safe and feasible and appears to be a better surgical choice for elderly patients aged over 70 years with gastric cancer because of its minimally-invasive advantage and less post-operative complications.

关 键 词：腹腔镜 胃癌根治 老年患者 安全性 

分 类 号：R735.2[医药卫生—肿瘤]