手术时间对接受腹腔镜辅助胃癌根治术老年患者预后的影响分析

目的:分析手术时间对接受腹腔镜辅助胃癌根治术的老年患者预后的影响,以探讨亚群预后的影响因素。方法:回顾分析70岁以上接受腹腔镜辅助胃癌根治术患者的临床资料。结果:X-tile软件证明手术时间影响患者预后的截断值为230 min,相较短手术时间组,长手术时间组的患者总体生存期较差(P=0.043);且肿瘤较大、TNM分期较高、术中出血较多(P>0.05);基于肿瘤大小及TNM分期的亚组生存分析提示,手术时间较短的患者总体生存期无统计学优势(P>0.05)。不同手术时间的老年胃癌患者术后并发症发生率差异无统计学意义(P>0.05)。单因素及多因素分析表明,肿瘤大小、TNM分期为此类患者预后的独立影响因素,手术时间不影响患者预后。结论:对于70岁以上且接受腹腔镜辅助胃癌根治术的患者,手术时间并非预后的影响因素,较大的肿瘤及较晚的肿瘤分期提示预后较差。

Effect of operative time on prognosis of elderly patients with laparoscopic assisted radical gastrectomy for gastric cancer

Objective:The aim of this study is to investigate the effect of operative time on the prognosis of elderly patients undergoing laparoscopic assisted radical gastrectomy for gastric cancer,and to explore the prognostic factors of patient in subgroup.Methods:The patients over 70 years old who underwent laparoscopic-assisted radical gastrectomy for gastric cancer were enrolled in this study.The clinicopathological features and the effect of operative time on the prognosis of these patients was retrospectively analyzed.Results:The X-tile software showed that optimal cut-off value for predicting prognosis was 230 min for operative time(P=0.043).The overall survival of long-time group was worse than that of short-time group(P=0.043).The proportion of patients with a larger tumor,higher TNM stage and more intraoperative bleeding in long-time group was significantly higher than that in short-time group(P>0.05).Survival analysis based on tumor size and TNM stage demonstrated that the patients with a shorter operative time did not exhibit a significant survival benefit compared with patients with a longer operative time(P>0.05).There was no significant difference in postoperative complications among elderly patients with different operative time(P>0.05).Univariate and multivariate analyses showed that only tumor size and TNM stage were independent prognostic factors of these patients,and the operation time was not a risk factor for the prognosis of these patients.Conclusions:For patients over 70 years old who underwent laparoscopic assisted radical gastrectomy,operation time is not a risk factors for the prognosis,larger tumor size and later TNM stage suggest a poor prognosis.