【摘要】 目的分析腹腔镜扩大根治术治疗老年直肠癌疗效及影响预后的因素,为治疗老年直肠癌提供方法。方法选取2015年5月-2017年4月攀枝花市中心医院普外科收治的老年直肠癌患者150例,全部患者均行腹腔镜扩大根治术治疗和术后随访,记录其术后3年生存率。根据随访患者的术后3年存活情况,将随访的病例分为死亡组和存活组。采用单因素分析和Logistic多因素回归模型分析老年直肠癌预后影响因素。结果 150例患者手术时间为(188.92±24.61)min,术中出血量为(121.39±28.75)mL,淋巴结清扫数(13.25±2.18)枚,术后引流量为(441.56±63.82)m L,术后通气时间为(1.73±0.59)d,术后住院时间为(13.72±2.60)d,术后并发症发生率为20.67%(31/150)。其中10例失访,140例成功随访,患者术后3年生存率为72.86%(102/140)。术后3年存活140例,其中存活组102例,死亡组38例,单因素分析表明,死亡组肿瘤分化程度、TNM分期、肿瘤直径、Dukes分期与存活组差异均有统计学意义(P<0.05);Logistic多因素回归模型分析显示,肿瘤分化程度、TNM分期、肿瘤直径、Dukes分期为腹腔镜扩大根治术治疗老年直肠癌患者预后的影响因素(P<0.05)。结论腹腔镜扩大根治术治疗老年直肠癌,术后患者预后与肿瘤分化程度、TNM分期、肿瘤直径、Dukes分期有关;腹腔镜扩大根治术有重要的临床应用价值。更多还原

【Abstract】 Objective To analyze the curative effect of laparoscopic extended radical surgery on rectal cancer in the elderly and prognostic influencing factors so as to provide clinical reference for treating the disease. Methods 150 elderly patients with rectal cancer who were admitted to central hospital of Panzhihua city from May 2015 to April 2017 were selected. All patients underwent laparoscopic extended radical resection and postoperative follow-up, and their 3-year survival was recorded. According to the 3-year survival status of the patients who were followed up, they were divided into death group and survival group. Univariate analysis and logistic multivariate regression model were used to analyze the prognostic factors of rectal cancer in the elderly. Results The operation time was(188.92 ± 24.61) min, the intraoperative blood loss was(121.39±28.75) m L, the number of lymph node dissection was(13.25 ± 2.18), the postoperative drainage volume was(441.56±63.82) m L, the postoperative ventilation time was(1.73 ± 0.59) d, the postoperative hospital stay was(13.72 ±2.60) d, and the incidence of postoperative complications was 20.67%(31/150). After 3 years, 140 cases survived, including 102 cases in survival group and 38 cases in death group. Univariate analysis showed that there were significant differences in tumor differentiation, TNM stage, tumor diameter and Dukes stage between both group(P<0.05); logistic multivariate regression model analysis showed that the degree of tumor differentiation, TNM stage, tumor diameter, and Dukes stage were the factors affecting the prognosis of elderly patients with rectal cancer treated by laparoscopic extended radical resection(P<0.05). Conclusion The prognosis of elderly patients with rectal cancer after laparoscopic extended radical resection is related to tumor differentiation, TNM stage,tumor diameter and Dukes stage; laparoscopic extended radical surgery has important clinical application value.更多还原