郝荣, 赵子伟, 尚宾, 李睿, 殷红专, 苏琪. 腹腔镜与开腹手术治疗老年直肠癌的短期生命质量比较[J]. 中国肿瘤临床, 2012, 39(19): 1430-1433. DOI: 10.3969/j.issn.1000-8179.2012.19.010
引用本文: 郝荣, 赵子伟, 尚宾, 李睿, 殷红专, 苏琪. 腹腔镜与开腹手术治疗老年直肠癌的短期生命质量比较[J]. 中国肿瘤临床, 2012, 39(19): 1430-1433. DOI: 10.3969/j.issn.1000-8179.2012.19.010
Rong HAO, Ziwei ZHAO, Bin SHANG, Rui LI, Hongzhuan YIN, Qi SU. Comparison of the Short-term Quality of Life of Elderly Patients Treated with Laparoscopic Rectectomy and with Open Surgery for Rectal Cancer[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2012, 39(19): 1430-1433. DOI: 10.3969/j.issn.1000-8179.2012.19.010
Citation: Rong HAO, Ziwei ZHAO, Bin SHANG, Rui LI, Hongzhuan YIN, Qi SU. Comparison of the Short-term Quality of Life of Elderly Patients Treated with Laparoscopic Rectectomy and with Open Surgery for Rectal Cancer[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2012, 39(19): 1430-1433. DOI: 10.3969/j.issn.1000-8179.2012.19.010

腹腔镜与开腹手术治疗老年直肠癌的短期生命质量比较

Comparison of the Short-term Quality of Life of Elderly Patients Treated with Laparoscopic Rectectomy and with Open Surgery for Rectal Cancer

  • 摘要:
      目的  探讨腹腔镜手术治疗老年直肠癌的短期生命质量。
      方法  收集2009年9月至2011年5月中国医科大学附属盛京医院结直肠肛门病外科年龄70岁以上直肠癌患者资料, 依据调查表及生命质量测定核心量表(QLQ-C30)中文第三版, 共收集132例完整资料, 分为腔镜组(LR组)54例, 开腹组(OR组)78例, 两组进行统计学比较。
      结果  两组均无死亡病例。LR组患者排气、进食、镇痛药使用、SIRS持续的时间及术后住院时间明显低于OR组(P < 0.01), LR组留置尿管时间及切口感染少于OR组(P < 0.05)、两组肿瘤下切缘距离、吻合口瘘、肠梗阻、尿潴留、术后转移率及无进展生存期比较差异均无统计学意义(P均 > 0.05)。术后2周在5个功能领域、1个症状领域(疼痛)、1个总体健康状况领域和4个单一领域(气促、食欲丧失、失眠、经济困难)对比, LR组优于OR组(P < 0.05)。4周后认知功能、疼痛、气促、食欲丧失、失眠领域比较, LR组与OR组比较差异无统计学意义(P > 0.05)。
      结论  腹腔镜直肠癌根治术使老年患者短期生命质量得到显著改善。

     

    Abstract:
      Objective  This work evaluates the short-term Quality of Life(QOL) of elderly rectal cancer(RC) patients treated with laparoscopy-guided radical rectectomy.
      Methods  From September 2009 to May 2011, the complete data of 132 elderly RC patients were obtained.Information from 54 elderly patients that underwent laparoscopic rectectomy(LR group) was compared with the other 78 patients treated with open rectectomy(OR group).
      Results  No surgery-related deaths occurred among the LR and OR groups.The air exhaustion and food intake time, the time of analgesic use, and occurrence of systemic inflammatory response syndrome (SIRS), as well as the hospital stay after surgery in the LR group were significantly shorter compared with the OR group(P < 0.01).The duration of indwelling catheter use and incision infection was less in the LR group than in the OR group(P < 0.05).No significant differences between the LR group and the OR group concerning the length of resected bowel, as well as the incidence of intestinal fistula, intestinal obstruction, urinary retention, the metastatic rate, and progression-free survival(PFS)(P > 0.05).The five functional domains(body, role, recognition, emotion and social function), three domains of symptom(fatigue, nausea and vomiting, pain), one domain of general health, and six single domains(shortness of breath, loss of appetite, insomnia, constipation, diarrhea, economic difficulties) 2 weeks after the surgery were significantly better in the LR group than in the OR group(P < 0.05).Four weeks after the surgery, no significant differences were observed between the LR group and the OR group in terms of cognitive function, pain, shortness of breath, loss of appetite, and insomnia(P > 0.05).
      Conclusion  Laparoscopic rectectomy improves the short-term QOL and is evidently beneficial for elderly RC patients.

     

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