Short-term Outcomes of Laparoscopic Colonic Surgery in Elderly Patients

老年病人接受腹腔鏡大腸癌手術之短期術後結果

黃偉倫(Wei-Lun Huang) ； 方川尹(Chuan-Yin Fang) ； 黃允中(Yun-Chung Huang) ； 朱峻廷(Chun-Ting Chu) ； 楊昕禕(Hsin-Yi Yang) ； 林怡成(I-Chen Lin)

《中華民國大腸直腸外科醫學會雜誌》 33卷1期 (2022/03) Pp. 34-40

https://doi.org/10.6312/SCRSTW.202203_33(1).11024

摘要

Purpose. Colonic cancer is a lethal disease, and laparoscopic colectomy was widely used as a standard procedure in Taiwan recently. Due to the current increase in aging of the population, colectomy is more frequently performed among the elderly. However, elderly patients are considered to be at high risk for radical surgery because of their decreasing functional reserves and increasing medical comorbidities. We aimed to compare the short-term outcomes of colonic surgery between patients aged ＞ 75 years and those aged 50-75 years in our hospital. Materials and Methods. A total of 111 patients with colonic cancer who underwent an elective laparoscopic colectomy between January and December 2020 were assigned to two groups: aged 50-75 years (n = 69) and ＞ 75 years (n = 42). Operative time, length of postoperative stay, days to resume a soft diet and postoperative complications were evaluated. Results. The elderly group showed a longer mean operative time, albeit it was not significantly different (172.2 ±50.3 vs. 193.7 ± 66.0 minutes, p = 0.055). Moreover, no significant difference was noted in the length of postoperative stay (8 vs. 9 days, p = 0.061) and the days to resume a soft diet (7.1 ± 1.7 vs. 7.6 ± 3.1, p = 0.354). Furthermore, elderly patients presented with significantly more frequent occurrence of comorbidity according to the Charlson classification (0.93 ± 0.86 vs. 1.21 ± 0.91, p ＜ 0.05) when compared with the younger patients, especially in terms of hypertension (48% vs. 69%, p = 0.029). No difference was noted in the major complications (14% vs. 26%, p = 0.127) such as anastomotic problems, pneumonia, wound infection, and ileus. Conclusion. Laparoscopic colectomy is a safe and feasible method for colonic cancer in elderly patients. The short-term complications of carefully selected elderly patients are similar to those of younger patients.

關鍵字

Colonic cancer ； Short-term outcomes ； Postoperative complications ； Elderly ； Surgery

並列摘要

引言：大腸癌是威脅生命的疾病。腹腔鏡大腸癌手術近年來在台灣已被廣返使用。隨著人口老齡化，需要接受大腸癌手術的老年患者數量逐漸增加。然而老年患者本身身體機能較差且共病較多，在接受手術時被認為風險較高。本篇研究比較大於75歲之患者與50至75歲之患者進行大腸癌手術的短期相關結果。方法：我們收集自2020年1月至2020年12月，共111位大於75歲之患者（69位）與50至75歲之患者（42位），進行腹腔鏡大腸癌手術之患者，進行評估並比較手術時間、住院天數、軟食進食時間以及術後並發症之差異。結果：我們的研究結果顯示老年組別平均手術時間較長（172.2分鐘vs. 193.7分鐘），但無統計上顯著意義。術後平均住院天數與平均第一次軟食進食時間在兩組間無統計學上顯著差異（8日vs. 9日）。老年組別本身較年輕組別有較多的共病（0.93種vs. 1.26種），特別是高血壓的比例較高（48% vs. 69%）。術後併發症中（14% vs. 26%），在吻合處相關併發症、肺炎、傷口感染與腸阻塞的比例無統計學上顯著意義。結論：腹腔鏡大腸癌手術對於老年病患為一種安全且可行的手術方式。經過仔細評估後，大於75歲之大腸癌患者接受腹腔鏡手術可以得到與較年輕患者相似的短期結果。

並列關鍵字

大腸癌 ； 短期術後結果 ； 術後病發症 ； 老年人 ； 手術

參考文獻

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