【作者】 姚强； 薛英威；

【Author】 Yao Qiang;XUE Ying-wei;Deparatment of Gastrointestinal Surgery, the third affiliated hospital,Harbin Medical University;

【机构】 胃肠外科哈尔滨医科大学附属第三医院；

【摘要】 目的:本研究评估行胃癌根治术的老年人(≥70岁)发生术后并发症及30天死亡的相关风险因素。方法:2004年1月至2012年12月共有3970例行胃癌根治术的病人入组。其中年轻组(<70岁)3202例病人,老年组(≥70岁)768例病人。回顾性分析这些病人的临床病理特点,并且评价其与术后并发症的关系。结果:两组并发症总的发生率相似,年轻组为26.7%,老年组为27.34%。呼吸道疾病是最常见的术后并发症。两组病人术后总体并发症和各项并发症之间无统计学差异(P>0.05)。糖尿病,心血管疾病,术前合并疾病数量(≥4种),手术当日输血(≥6 U),ASA分级3级,手术时间(≥240 min),术前联合用药(≥4种)与老年病人术后发生并发症相关。术后合并4种及以上并发症老年病人与少于4种并发症的病人相比,术后两组30天死亡率有统计学差异。结论:高龄不是行胃癌根治术的老年病人发生术后并发症和30天死亡率的风险因素。同时存在4种及以上并发症的老年病人死亡率高。更多还原

【Abstract】 Purpose:This study was designed to identify risk factors for complications and30-day mortality in elderly patients(≥70 years) undergoing radical gastrectomy in order to establish appropriate treatment for these patients.Methods:A retrospective study assessed the risk factors for postoperative complications and mortality in 3,970 patients who underwent radical gastrectomy for gastric cancers.Patients were enrolled from January 2004 to December 2012.The clinicopathologic features of 3,202 younger patients(≤70 years) were compared with those of 768 elderly patients(≥70 years).Results:The overall incidence of postoperative complications in younger(26.7%) versus older patients(27.34%) were similar.Respiratory disease was the most frequent complication.There were no significant differences in the overall incidence and the incidence of each individual postoperative complication(P>0.05) between the two groups.Diabetes,cardiovascular disease,the number of preoperative comorbidities(≥4),transfusion on the day of surgery(≥6 U),American Society of Anesthesiologists class 3,surgical duration(>240 min),polypharmacy ≥4medications) were associated with postoperative complications for elderly patients.Among patients with 4 or more different postoperative complications,30-day mortality was statistically different,compared to those with fewer than 4 complications.Conclusions:Advanced age is not a risk factor for postoperative complications and mortality in patients with radical gastrectomy.Patients with at least 4 postoperative complications had higher mortality rates.更多还原