CAJ | 학술논문

目的探讨年龄对老年人结直肠癌手术治疗后临床结局的影响.方法回顾性总结我院1999年1月至2007年12月结直肠癌手术患者的临床资料1249例,根据年龄分为研究组(≥75岁,312例)和对照组(<75岁,937例).结果 (1)研究组的平均年龄明显高于对照组(t=33.09,P<0.05),具有营养不良风险的比例、并存其他疾病的比例、近端结肠肿瘤的比例、区域淋巴结转移的比例明显高于对照组(χ2值分别为47.33、130.75、21.24、45.33,均P<0.05);(2)研究组术前外科并发症的发生率、肠梗阻的发生率、急诊手术的比例明显高于对照组(χ2值分别为26.81、34.14、10.72,均P<0.05),研究组的手术切除率明显低于对照组(χ2=9.732,P<0.05);(3)研究组术后总并发症的发生率、一般并发症的发牛率和围手术期病死率明显高于对照组(χ2值分别为19.38、20.75、10.11,均P<0.05);(4)研究组2年生存率和5年生存率明显低于对照组(χ2值分别为11.91、27.17,均P<0.05);但研究组2年肿瘤特异生存率和5年瘤特异生存率与对照组的差异无统计学意义.结论术前并存疾病、术前外科并发症、肿瘤的局部转移和术后非外科并发症影响老年人结直肠癌术后的临床结局.
목적 탐토년령대노년인결직장암수술치료후림상결국적영향.방법 회고성총결아원1999년1월지2007년12월결직장암수술환자적림상자료1249례,근거년령분위연구조(≥75세,312례)화대조조(<75세,937례).결과 (1)연구조적평균년령명현고우대조조(t=33.09,P<0.05),구유영양불량풍험적비례、병존기타질병적비례、근단결장종류적비례、구역림파결전이적비례명현고우대조조(χ2치분별위47.33、130.75、21.24、45.33,균P<0.05);(2)연구조술전외과병발증적발생솔、장경조적발생솔、급진수술적비례명현고우대조조(χ2치분별위26.81、34.14、10.72,균P<0.05),연구조적수술절제솔명현저우대조조(χ2=9.732,P<0.05);(3)연구조술후총병발증적발생솔、일반병발증적발우솔화위수술기병사솔명현고우대조조(χ2치분별위19.38、20.75、10.11,균P<0.05);(4)연구조2년생존솔화5년생존솔명현저우대조조(χ2치분별위11.91、27.17,균P<0.05);단연구조2년종류특이생존솔화5년류특이생존솔여대조조적차이무통계학의의.결론 술전병존질병、술전외과병발증、종류적국부전이화술후비외과병발증영향노년인결직장암술후적림상결국.
Objective To explore the effect of age on clinical postoperative outcomes of elderly patients with colorectal cancer undergoing surgical treatment. Methods The clinical data of 1249 patients from January 1999 to December 2007 were analyzed retrospectively, and patients were divided into two groups according to age; the study group (≥75 years, n=312) and the control group (<75 years, n=937). Results (1) The average age was significantly higher in study group than in control group (t=33.09,P<0.05), and the rates of malnutrition risk, co-morbidity, tumor in right colon and local Iymphonodus metastasis were significantly higher in study group than in control group (x2=47.33, 130.75, 21.24 and 45.33, P<0.05). ( 2 ) The rates of preoperative surgical complications, bowel obstruction and emergency operation were significantly higher in study group than in control group (x2 =26.81, 34.14 and 10.72, P<0.05) . The rate of resection was significantly lower in study group than in control group (x2 =9.732, P<0.05). (3) The overall incidences of postoperative complications, general complications and mortality of perioperative period were significantly higher in study group than in control group (x2= 19.38, 20.75 and 10.11,P<0.05). (4) The two-year survival and five-year survival were significantly lower in study group than in control group (x2=11.91 and 27.17, P<0.05), but there were no significant differences in the cancer-specific two-year survival and five-year survival between the both groups. Conclusions Preoperative complications and co-morbidities, local tumor metastasis and postoperative nonsurgical complications adversely affect the postoperative outcomes for elderly patients with colorectal cancer.