老年周围脏器浸润性直肠癌的不同外科术式治疗评价

目的探讨老年周围脏器浸润性直肠癌患者安全有效的外科治疗方法。方法选取86例老年周围脏器浸润性直肠癌患者并随机分为两组,43例患者采用联合脏器整块切除术（MVR）以及联合远处转移灶根治性切除术作为观察组,43例患者采用局部切除术作为对照组,观察比较两组患者术后并发症发生情况,随访两组患者3年,观察两组患者术后1、3年生存率、肿瘤复发或转移,同时采取生活质量综合评定问卷进行问卷调查和评估。结果观察组术后1年生存率为90.70%,3年生存率为81.39%,对照组术后1年生存率为81.39%,3年生存率为60.46%,观察组术后1年生存率较对照组差异无统计学意义（P〉0.05）,观察组术后3年生存率明显高于对照组,差异有统计学意义（P〈0.05）。观察组术后并发症发生率为27.91%,对照组为16.28%,观察组术后并发症发生率高于对照组,但差异无统计学意义（P〉0.05）。观察组术后生活质量评分为（37.8±12.4）分,对照组为（30.4±7.7）分,观察组生活质量评分明显高于对照组（P〈0.05）。观察组3例（6.98%）复发或转移,对照组12例（27.91%）复发或转移,观察组随访期间肿瘤复发或转移率明显低于对照组（P〈0.05）。结论对老年周围脏器浸润性直肠癌患者在严格筛选适应征的情况下,采用联合脏器整块切除术（MVR）以及联合远处转移灶根治性切除术,可降低术后肿瘤复发或转移,提高近期生存率,改善患者生活质量。

Elderly surrounding organs invasive cancer surgery surgical treatment evaluation.

Objective To investigate safe and effective surgical treatment of elderly patients with invasive cancer surrounding organs.Methods 86 cases of elderly surrounding organs invasive cancer patients were randomly divided into two groups,43 patients with combined organ en bloc resection（MVR） as well as joint radical resection of distant metastases as the observation group,43 The patients were treated with local excision as a control group,were compared between the two groups was observed in patients with postoperative complications,the 3-year follow-up of two groups of patients,the observed postoperative 1-year survival rate,3-year survival,tumor recurrence or metastasis,while taking the prevention,at the same time through comprehensive evaluation quality of life questionnaire survey and evaluation.Results The 1-year survival rate of the observation group was 90.70%,the 3-year survival rate was 81.39%,the control group after 1-year survival rate was 81.39%,the 3-year survival rate was 60.46%,the 1-year survival rate of the observation group were slightly in the control group,but the difference was not significant（P〈0.05）,and 3-year survival rate of the observation group were significantly higher than that in the control group,the difference was statistically significant（P〈0.05）.Observation group,postoperative complication rate was 27.91%,and 16.28% in the control group,postoperative complication rate was higher in the observation group,but the difference was not significant（P〈0.05）.The observed postoperative quality of life score（37.8±12.4） minutes,the control group（30.4±7.7）,quality of life score of the observation group was significantly higher than that in the control group（P〈0.05）.Observed in 3 cases（6.98%） recurrence or metastasis,recurrence or metastasis in the control group,12 cases（27.91%）,the follow-up period of observation group tumor recurrence or metastasis was significantly lower than the control group（P〈0.05）.Conclusion surrounding organs of elderly patients with invasive cancer in the case of strict screening adaptation levy,combined organ en bloc resection（MVR） as well as the Joint distant metastases radical resection,can reduce tumor recurrence or transfer to improve near-term survival and improve the quality of life of patients.