中国癌症杂志 ›› 2014, Vol. 24 ›› Issue (2): 151-154.doi: 10.3969/j.issn.1007-3969.2014.02.012

• 论著 • 上一篇    下一篇

老年胸段食管鳞癌患者的手术安全性分析

吴杲,魏大中,解明然,田界勇,马冬春   

  1. 安徽医科大学附属省立医院胸外科,安徽 合肥230001
  • 出版日期:2014-02-28 发布日期:2014-03-07
  • 通信作者: 魏大中 E-mail:xweidazhong195605@163.com

The surgical safety analysis of elderly patients with thoracic esophageal squamous cell carcinoma

WU Gao,WEI Da-zhong,XIE Ming-ran,TIAN Jie-yong,MA Dong-chun   

  1. Department of Thoracic Surgery, Provincial Hospital Affiliated to Anhui Medical University, Hefei Anhui 230001, China
  • Published:2014-02-28 Online:2014-03-07
  • Contact: WEI Da-zhong E-mail: weidazhong195605@163.com

摘要:

背景与目的:老年食管癌发病率呈上升趋势。本研究旨在比较高龄老人和年轻老人两组胸段食管鳞癌患者临床病理资料、手术及术后情况,分析不同手术入路对高龄老年患者的影响。方法:回顾性分析20061月—200812月安徽医科大学附属省立医院胸外科收治的胸段食管鳞癌老年患者(60岁以上)371例。其中≥75岁的高龄老人53例,60~74岁的年轻老人318例,分别比较两组患者临床病理特征、手术情况、并发症及术后院内死亡率和平均住院时间,同时根据手术入路不同分为左进胸入路与右进胸入路,比较手术时间、术中出血量及术后并发症发生率等情况。结果:高龄老人组与年轻老人组相比术前合并症更多,术前ASA分级更高,术后并发症、住院时间及院内死亡率均明显增高,高龄老人组左胸入路较右胸入路术后并发症特别是肺部并发症更少(13.0% vs 40.0%),差异有统计学意义(P<0.05)结论:75岁的老年胸段食管鳞癌患者手术风险较大,可以通过选择相对简单的手术方式,减少术后并发症特别是肺部并发症的发生率。

关键词: 高龄, 食管癌, 手术, 术后并发症

Abstract:

Background and purpose: The incidence rate of elderly esophageal carcinoma patients is increasing year by year. In this study, the clinicopathologic factors, operational factors and postoperative complications were compared between the older and the younger elderly patients with thoracic esophageal squamous cell carcinoma (ESCC), and the influence of different surgical approaches to older elderly patients were analyzed. Methods: A retrospective review of 371 cases of elderly patients with thoracic esophageal squamous cell carcinoma (60 years) between Jan. 2006 and Dec. 2008 were performed. The patients were divided into two age groups. The patients over 75 years old named the older elderly group including 53 patients, and the patients between 60-74 years named the younger elderly group including 318 patients, the clinicopathological factors, operational factors, postoperative hospital mortality and average length of stay were compared. Meanwhile, according to different surgical approaches, the comparison of the left chest and right chest approach of operative time, blood loss and postoperative complication rate, and so on and so forth. Results: The older elderly group compared with the younger elderly group had more preoperative complications. Preoperative ASA classification and postoperative complications, length of stay and hospital mortality rates were significantly higher. The older elderly group over the right chest approach had less postoperative complications, especially pulmonary complications, the results were statistically significant.(13.0% vs 40.0%P<0.05) Conclusion: The patients over 75 years old with thoracic esophageal squamous cell carcinoma have a higher risk during the operation, we can choose relatively simpler operation approach to reduce the incidence of postoperative complications, especially pulmonary complications.

Key words: Elderly, Esophageal cancer, Surgery, Postoperative complication