论文部分内容阅读
目的探讨老年人结直肠癌的外科治疗。方法对复旦大学附属肿瘤医院1985年1月至2003年12月间手术治疗的266例年龄≥75岁的老年人结直肠癌病例资料,进行临床和病理资料的回顾性分析。结果266例中,男性151例,女性115例,年龄75~91岁。病变部位以直肠和乙状结肠多见,占69.2%,但右半结肠癌仍占22.2%。94例(35.3%)术前存在心血管疾病、糖尿病等合并症。215例(80.8%)行根治性手术,35例(13.2%)行姑息性手术治疗。术后30例(11.3%)出现肠梗阻、出血、感染等并发症,其中3例(占1.1%)手术后死亡。全组随访1个月至16年,5年存活率51.3%。结论虽然老年人结直肠癌中术前合并症和术后并发症的发生率较高,但在重视围手术期的检测和处理后手术死亡率并未增加,术后5年存活率仍可达50%以上。因此,对老年人结直肠癌积极的临床诊治不容忽视。
Objective To investigate the surgical treatment of colorectal cancer in the elderly. Methods A retrospective analysis of clinical and pathological data was performed on 266 cases of colorectal cancer aged 266 or older who underwent surgical treatment from January 1985 to December 2003 at the Affiliated Tumor Hospital of Fudan University. Results 266 cases, 151 males and 115 females, aged 75 to 91 years. Lesions are more common in the rectum and sigmoid colon, accounting for 69.2%, but right colon cancer still accounted for 22.2%. 94 cases (35.3%) preoperative presence of cardiovascular disease, diabetes and other complications. 215 cases (80.8%) underwent radical surgery and 35 cases (13.2%) underwent palliative surgery. Postoperative 30 cases (11.3%) showed intestinal obstruction, bleeding, infection and other complications, of which 3 (1.1%) died after surgery. The whole group was followed up for 1 month to 16 years, and the 5-year survival rate was 51.3%. Conclusions Although the incidence of preoperative complications and postoperative complications in colorectal cancer is high in elderly patients, the mortality rate after perioperative examination and treatment has not been increased, and the 5-year survival rate remains high above 50. Therefore, the positive clinical diagnosis and treatment of colorectal cancer in the elderly can not be ignored.