高龄结肠直肠癌病人围术期的外科治疗

目的探讨高龄结、直肠癌病人围术期的外科治疗方法。方法回顾性分析2001年至2009年间76例70岁以上结、直肠癌病人围术期的外科治疗资料。结果高龄结、直肠癌病人入院前误诊率高（44／76），并存病多（46／76），肿瘤切除率为90％，术后并发症发生率为37％，围手术期病死率为8％。结论①结直肠癌和其他大部分癌症一样是一种随年龄增高而发病率不断上升的恶性肿瘤。②高龄结、直肠癌病人有发病缓慢、症状隐匿、并存病多的特点。③老年人结直肠癌易误诊。④高龄结、直肠癌病人的术前准备主要是并存病的治疗。围术期并存病的治疗是降低手术病死率的关键。⑤治疗方案选择要严格遵循控制性损伤外科的理念（Damage control surgery。DCS）。手术切除是高龄结、直肠癌病人最好的治疗方法。⑥并发症的治疗极为重要。

Surgical treatment during perioperative period in elederly patients with colorectal cancer

Objective To study the surgical treatment of elderly patients with colorectal cancer. Methods Between 2001 and 2009, surgical treatment datas of 76 cases of edlerly patients with colorectal cancer during perioperative period were retrospectively analyzed. Results Elderly colorectal cancer patients misdiagnosed before admission （44/76）, coexisting diseases and more （46/76）, tumor resection rate was 90%, postoperative complication rate was 37%, perioperative mortality rate was 8%. Conclusions （1）Colorectal cancer increases with age like the other malignant tumors. （2）Elderly colorectal cancer patients with slow onset, symptoms hidden, comorbidities and more features. （3）Elderly colorectal cancer is often misdiagnosed. （4）Elderly colorectal cancer patient＇ s preoperative preparation is mainly the treatment of coexisting diseases. Perioperative treatment of coexisting diseases is the key to reducing mortality.（5） Treatment options should strictly follow the concept of controlled surgical injury （Damage control surgery, DCS）. Surgical resection is the best treatment for elderly colorectal cancer patient. （6）Treatment of complications is very important.