| Introduction: Worldwide, colorectal cancer is the3rd most common type of cancer.In recent years, due to changes in eating habits and the aging of the population, themorbidity of colorectal cancer is increasing. Adjuvant therapy, such as chemotherapyand radiotherapy, can improve survival in colorectal cancer patients. However, the onlytreatment with curative intent is surgical resection of the tumor. But patients withcolorectal cancer who is older than70years are often associated with varieties ofchronic diseases of internal medicine, lower body function reserves and poor toleranceto surgery. Therefore, the rate of postoperative complication often appears higher. In thisstudy, we compare the data of50patients with colorectal cancer who is older than70inlaparoscopic surgery group and open operation group. And we illustrate the advantagesof laparoscopic surgery of colorectal cancer in elderly patients by analysing thepreoperative, intraoperative and postoperative clinical indicators in different groups.Material and Methods: This study uses a retrospective analysis. We randomlyselected50clinical data of the elderly patients with colorectal cancer from January of2010to December of2013in The Second Affiliated Hospital of Dalian MedicalUniversity according to requirements of the laparoscopic surgery group and the openoperation group.25patients underwent laparoscopic assisted resection of colorectalcancer, and they were set in the experimental group. The other25patients received opensurgery, as the control group. We compared the ASA grade, the bleeding volume, theoperation time, hypercapnia during operation, the indexes of operation effect, theindexes of postoperative recovery, the time stay in hospital andpostoperative complications in3months in this two groups. By comparing the operative effects in different groups, we illustrate the practical value and the advantages inlaparoscopic surgery in the patients older than70years with colorectal cancer.Results:①All colorectal cancer operations were completed successfully. In theexperimental group, there was no case that converted to open operation. There was nodifferent (P>0.05) when compared gender, age, ASA grade, tumor stage, surgicalapproach, and mortality in this two groups.②The operation time ofexperimental group was longer than the control group (204±62.32min vs157.6±69.25min, P=0.016).③Hypercapnia occurred during the operation in theexperimental group is more than the control group (24%vs4%, P=0.042).④Theamount of bleeding in the experimental group was significantly less than the controlgroup (100±50ml vs150±100ml, P=0.001).⑤The indexes of operationeffect, including the length of excisional intestine, the positive rate of margin, thenumber of lymph node, showed no significant difference (P>0.05) in two groups.⑥The indexes of postoperative recovery, including the amount of hemoglobin andalbumin one day after operation and postoperative catheter period showed no difference(P>0.05) between two groups. But comparing with the control group, the experimentalgroup showed better effect in time to flatus (3.16±1.03d vs3.96±1.49d, P=0.032) andtime to intake liquid diet (3.44±1.12d vs4.24±1.61d, P=0.047) after operation.⑦Thetime stay in hospital in the control group was shorter than the experimentalgroup(15.92±4.30d vs20.32±8.88d, P=0.032). The difference of the time stay inhospital was statistically significant.⑧The rate of postoperation complications in3months in experimental group was significantly less than the control group (8%vs44%, P=0.004).Conclusions: The indexes of operation effect, including the length of excisionalintestine, the positive rate of margin, the number of lymph node, showed no significantdifference in two groups. The defects of laparoscopic surgery were that theoperation time was longer and the hypercapnia rate during operation was higher thanopen operation. But with the development of technology and experience, we canovercome these disadvantages. While the use of laparoscopic surgery in elderly patients with colorectal cancer has the advantages of smaller trauma, less amount ofbleeding, faster postoperative recovery, shorter hospitalization time and lesspostoperative complications in3months. It is a safe and feasible operation approachand it is worthy of clinical application. |
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