| Objective: To compare the laparoscopic-assisted and conventional openanterior resection of rectum in elderly patients and discuss the feasibility,safety and clinical application value of laparoscopic-assisted anteriorresection of resection for elderly patients.Materials and methods: We retrospectively analyzed the data of215cases of elderly patients who undertaken anterior resection of rectumfrom January2010to April2014in the Department of General Surgery,Xinmin Branch of The China-Japan Union Hospital, Jilin University.There are117laparoscopic-assisted operation cases (including81maleand36female patients, the mean age is75.79±2.17year-old) and98conventional open operation cases (including72male and26femalepatients, the mean age is76.42±3.56year-old). After data processing, wecompared the mean operation time, the total number of retrieved lymphnodes, the mean blood loss volume, the incision length, the mean time forpassage of flatus, the mean duration of hospitalization, the mean hospitalstay in Intensive Care Unit（ICU）, the postoperative complication rates（including intestinal fistula, subcutaneous infection, anastomoticleakage, intestinal obstruction, urinary tract infection, pulmonary infection）, the postoperative mortality within30days and theprogression-free survival rates within1year of two groups.Result: The anterior rectum resections were successfully completedaccording to TME principle in both groups. The laparoscopic-assistedgroup’s and laparotomy group’s mean operation time is(119.56±29.70)min and (100.23±19.76)min (P<0.05), respectively; thetotal number of retrieved lymph nodes are19.30±4.21and14.49±2.32(P<0.05), respectively; the mean blood loss volume is (48.98±31.18)mland (81.37±39.76)ml (P<0.05), respectively; the incision length is (5.30±0.51)cm and (18.45±2.02)cm (P<0.05), respectively; the mean timefor passage of flatus is (2.13±1.37)d and (3.53±1.09)d (P<0.05),respectively; the mean duration of hospitalization is (6.42±1.35)d and(8.49±2.38)d (P<0.05), respectively; the mean hospital stay in ICU is(1.20±0.20)d and (2.30±0.40)d (P<0.05), respectively; all these aboveindexes of the two groups are statistically significant. Thelaparoscopic-assisted group’s and laparotomy group’s postoperativeintestinal fistula rates are1.71%（2/117） and3.06%（3/98）, respectively;the subcutaneous infection rates are0.85%（1/117）and5.10%（5/98）,respectively; the anastomotic leakage rates are1.71%（2/117）and5.10%（5/98）,respectively; the intestinal obstruction rates are2.56%（3/117）and4.08%（4/98）, respectively; the urinary tract infection rates are4.27%（5/117） and4.08%（4/98）,respectively; the pulmonary infection ratesare2.56%（3/117）and2.04%（2/98）, respectively; the postoperativemortalities within30days are1.71%（2/117）and1.02%（1/98）,respectively; the progression-free survival rates within1year are91.30%（105/115）and91.75%（89/97）,respectively; all these above indexes of the two groups are of no statistical significance.Conclusion: Laparoscopic-assisted anterior resection of rectum is afeasible and effective operative method and it is also suitbale for elderlypatients. |
