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目的分析探讨老年大肠癌的外科治疗及病理特点。方法回顾性分析2003年1月至2010年12月187例手术治疗并经病理确诊的65岁以上老年大肠癌的临床资料。分析患者发病的肿瘤部位、病理分期、组织分型,并与同期收治的214例65岁以下的大肠癌患者进行比较。结果男119例,女68例,年龄65～93岁,平均70.5岁。有肠梗阻表现35例,急诊手术25例,肿瘤位于直肠占36.9%,位于乙状结肠占30.5%,其后依次为结肠肝曲、回盲部、结肠脾曲、横结肠、升结肠和降结肠。中分化腺癌125例(66.8%),高分化腺癌28例(15.0%),低分化腺癌32例(17.1%),未分化腺癌2例(1.1%)。Dukes A期31例,B期72例,C期67例,D期17例。结论老年大肠癌组织分型好、分化程度高、临床分期较早,以恶性程度较低的腺癌最为常见。对老年大肠癌患者应积极行外科手术治疗,并重视老年患者围手术期的监测和处理。
Objective To analyze the surgical treatment of elderly colorectal cancer and pathological features. Methods A retrospective analysis of 187 cases of surgical treatment from January 2003 to December 2010 and pathologically confirmed the clinical data of elderly patients over 65 years old with colorectal cancer. Analysis of the incidence of the patient’s tumor site, pathological staging, tissue typing, and with the same period were treated 214 cases of patients under 65 years of age colorectal cancer were compared. Results There were 119 males and 68 females, aged 65-93 years, with an average age of 70.5 years. There were 35 cases of intestinal obstruction, 25 cases of emergency surgery, the tumor located in the rectum accounted for 36.9%, located in the sigmoid colon accounted for 30.5%, followed by colon liver song, ileocecal, colon splenic song, transverse colon, ascending colon and descending colon. There were 125 cases (66.8%) of differentiated adenocarcinoma, 28 cases of well-differentiated adenocarcinoma (15.0%), 32 cases of poorly differentiated adenocarcinoma (17.1%) and 2 cases of undifferentiated adenocarcinoma (1.1%). Dukes A 31 cases, B 72 cases, C 67 cases, D 17 cases. Conclusion The classification of colorectal cancer in old patients is good, the degree of differentiation is high, the clinical stage is earlier, and the adenocarcinoma with lower malignancy is the most common. The elderly patients with colorectal cancer should be actively treated with surgery, and pay attention to the elderly perioperative monitoring and management.