Clinical application of fast track surgery, laparoscopic radical resection of rectal cancer in elderly patients / 中国医师杂志

ABSTRACT

Objective To investigate the curative effect of fast track surgery laparoscopic surgery and traditional laparotomy in elderly patients over 70 years old with rectal cancer and the difference between the two groups was analyzed,and explore the practical value and the advantages in fast track surgery (FTS) laparoscopic surgery in the patients older than 70 years with colorectal cancer.Methods This study was a retrospective analysis,in accordance with the requirements of the laparoscopic group and the laparotomy group,the clinical data of 100 patients over 70 years old with rectal cancer were randomly sampled who were admitted to the second people's Hospital of Hunan province in April 2010-2016 November.Fifty patients underwent FTS laparoscopic assisted rectal cancer,which was set as the experimental group;the other 50 patients underwent conventional open surgery were set as the control group.The clinical data of two groups were compared with preoperative,intraoperative and postoperative related indicators.Results No significant difference was found in the two groups of patients in surgery (P ＞ 0.05).The operative time of experimental group was [(190 ± 35.2) min] longer than the control group [(160.5 ± 29.3) min] (P ＜ 0.05).The incidence of hypercapnia in the experimental group was higher than the control group (P ＜ 0.05).The intraoperative bleeding of the experimental group [(90 ± 40) ml] was significantly less than the control group [(130 ± 60)ml,P ＜0.05].The postoperative exhaust time of the experimental group [(3.01 ± 0.98)d] was shorter than the control group [(3.98 ± 1.38)d,P ＜0.05].The lymph node number of the experimental group (12.86 ±4.87) was not significantly different from control group (13.12 ±4.69,P ＞ 0.05).The hospitalization time of the experimental group [(15.68 ±5.10) d] was significantly shorter than the control group [(20.31 ± 6.78) d,P ＜ 0.05].The wound infection rate of experimental group was significantly lower than the control group (P ＜ 0.05).The anastomotic leakage in experimental group was not significantly different from control group (P ＞ 0.05).No significant difference in anastomotic stenosis was found between the experimental group and the control group (P ＞ 0.05).Conclusions The concept of FTS laparoscopic radical resection of rectal cancer has the advantages including less bleeding,quicker recovery,and less complications.It is safe and feasible and worthy of clinical application.