在70岁及以上的患有直肠癌的老年患者中, laparoscopic 和开放的手术管理相比
Xiaolong Li1, Hengwei Zhang1, Xudong Hou1
1Department of General Surgery, First Hospital of Lanzhou University, Lanzhou, Gansu Province, China.
Journal of minimal access surgery
|June 7, 2023
概括
对于老年直肠癌患者的腹腔镜手术提供了比开放手术更快的恢复和更少的并发症,具有类似的长期生存率. 这种最少的侵入性方法对这个人群有明显的好处.
科学领域:
- 手术瘤学手术瘤学
- 胃肠道手术 胃肠道手术
- 老年医学 老年医学
背景情况:
- 老年患者的直肠癌治疗存在独特的挑战.
- 越来越多地探索微创手术技术,以改善患者的治疗结果.
- 在这个人口群体中比较腹腔镜与开放式手术对于基于证据的实践至关重要.
研究的目的:
- 为了比较腹腔镜手术与开放手术的短期和长期外科结果.
- 评估这些方法在患有直肠癌的老年患者 (≥70岁) 中的安全性和有效性.
主要方法:
- 对接受彻底手术的老年直肠癌患者的回顾性分析.
- 倾向性得分匹配 (1:1比) 以控制基线特征.
- 术后并发症,康复指标和整体存活率 (OS) 的比较.
主要成果:
- laparoscopic 手术显示显著缩短恢复时间 (止痛药,平,饮食,住院) 和减少血液损失.
- 术后并发症的发生率在腹腔镜组 (17.7%) 与开放手术组 (30.6%) 相比较较低.
- 在腹腔镜和开放手术组之间没有观察到平均整体存活时间的显著差异.
结论:
- 腹腔镜外科手术为老年直肠癌患者提供了减少创伤和更快恢复的优势.
- 这种方法提供了与开放性手术相比较的长期预后结果.
- 腹腔镜手术是这个患者群体的可行和潜在的优越选择.
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