高龄老年胃癌患者行D2根治性切除术后疗效分析  

The outcome of radical operation (D2) for elderly patients with gastric carcinoma

作　　者：袁建伟[1] 何小虎 朱磊 马军[1] 周潮平[1] 张亚铭[1] YUAN Jianwei;HE Xiaohu;ZHU Lei;MA Jun;ZHOU Chaoping;ZHANG Yaming(Department of Surgical Oncology,Anqing Municipal Hospital Affiliated to Anhui Medical University,Anqing 246000,China)

机构地区：[1]安庆市立医院肿瘤外科

出　　处：《中国肿瘤外科杂志》2019年第6期433-437,共5页Chinese Journal of Surgical Oncology

摘　　要：目的分析高龄老年胃癌患者性D2根治性切除术后的近期并发症、死亡率和远期生存情况。方法选取2010年9月至2015年6月在安庆市立医院肿瘤外科行胃癌根治术(D2)的患者188例,其中高龄组(≥75岁)61例,对照组(60~65岁)127例。比较两组患者的术前合并症、围手术期死亡率、术后并发症及其术后生存情况。结果高龄组术前合并症发生率(70.5%)高于对照组(44.9%),差异有统计学意义(P=0.001)。高龄组最常见的术前合并症为贫血(29.5%)、高血压(23.0%)、肺疾病(23.0%)、心血管疾病(11.4%)、肝脏疾病(8.6%),其中包含2种合并症的占21.3%,3种及以上合并症的占16.4%。高龄组术后并发症发生率(36.1%)与对照组(26.8%)比较差异无统计学意义(P=0.192)。高龄组术后肺部感染(22.0%)和心衰(3.3%)的发生比例高于对照组(分别为6.3%、0%)。高龄组术后5年生存率与对照组差异无统计学意义(59.9%vs.64.6%,P=0.390)。结论高龄组胃癌患者与对照组行D2根治术后的手术并发症发生率、围手术期死亡率和总生存期无明显差异,手术安全可行。高龄早期胃癌患者应注意合并症和继发恶性肿瘤的发生。Objective The aim of this study was to clarify the operative mortality、short-term outcome and long-term survival of gastrectomy(D2)for elderly patients with gastric cancer.Methods Clinical data of patients with gastric cancer who underwent gastrectomy in Department of Surgical Oncology,Anqing Municipal Hospital affiliated to Anhui Medical University between September 2010 and June 2015.Classified as elderly group(≥75 years-old,61 patients)and control group(60-65 years-old,127 patients).The preoperative complications,perioperative mortality and postoperative complications were compared between the two groups,and the survival data were analyzed.Results The incidence of preoperative complications in the elderly group(70.5%)was significantly higher than that in the control group(44.9%).The most common preoperative comorbidities were anemia(29.5%),followed by hypertension(23%),lung disease(23%),cardiovascular disease(11.4%)and liver disease(8.6%),including 21.3%of the two comorbidities,16.4%of the three or more comorbidities.The elderly group had higher preoperative comorbidities than the control group(P=0.001).Univariate analysis showed that preoperative comorbidities(P=0.041)and the number of comorbidities(≥3)(P=0.015)were risk factors for postoperative complications.There was no significant difference in the incidence of postoperative complications between the elderly group(36.1%)and the control group(26.8%)(P=0.192).Postoperative pulmonary infection(22%)and heart failure(3.3%)in the elderly group were higher than those in the control group(6.3%)and(0%).The 5-year survival rates of the elderly patients and the control group were 64.6%and 59.9%(P=0.390).Conclusions There was no significant difference in the incidence of complications,perioperative mortality and OS between the elderly patients and the control group.The operation was safe and feasible.Complications and the number of complications are risk factors for complications after operation in elderly patients.The elderly patients with early gastric cancer

关 键 词：胃肿瘤 老年人 胃切除术 远期疗效 术后治疗 

分 类 号：R73[医药卫生—肿瘤]