| 1 | Systematic review of laparoscopic vs open surgery for colorectal cancer in elderly patients显示文摘AIM: To verify the safety and validity of laparoscopic surgery for the treatment of colorectal cancer in elderly patients.METHODS: A meta-analysis was performed of a systematic search of studies on an electronic database. Studies that compared laparoscopic colectomy(LAC) in elderly colorectal cancer patients with open colectomy(OC) were retrieved, and their short and long-term outcomes compared. Elderly people were defined as 65 years old or more. Inclusion criteria were set at: Resection of colorectal cancer, comparison between laparoscopic and OC and no significant difference in backgrounds between groups.RESULTS: Fifteen studies were identified for analysis. LAC was performed on 1436 patients, and OC performed on 1810 patients. In analyses of short-term outcomes, operation time for LAC was longer than for OC(mean difference = 34.4162, 95%CI: 17.8473-50.9851, P < 0.0001). The following clinical parameters were lower in LAC than in OC: Amount of estimated blood loss(mean difference =-93.3738, 95%CI:-132.3437 to-54.4039, P < 0.0001), overall morbidity(OR = 0.5427, 95%CI: 0.4425-0.6655, P < 0.0001), incisional surgical site infection(OR = 0.6262, 95%CI: 0.4310-0.9097, P = 0.0140), bowel obstruction and ileus(OR = 0.6248, 95%CI: 0.4519-0.8638, P = 0.0044) and cardiovascular complications(OR = 0.4767, 95%CI: 0.2805-0.8101, P = 0.0062). In analyses of long-term outcomes(median follow-up period: 36.4 mo in LAC, 34.3 mo in OC), there was no significant difference in overall survival(mean difference = 0.8321, 95%CI: 0.5331-1.2990, P = 0.4187) and disease specific survival(mean difference = 1.0254, 95%CI: 0.6707-1.5675, P = 0.9209). There was also no significant difference in the number of dissected lymph nodes(mean difference =-0.1360, 95%CI:-4.0553-3.7833, P = 0.9458).CONCLUSION: LAC in elderly colorectal cancer patients had benefits in short-term outcomes compared with OC except operation time. The long-term outcomes and oncological clearance of LAC were similar to that of OC. These results support the assertion that LAC is an effective procedure for elderly patients with colorectal cancer. | Shoichi Fujii Mitsuo Tsukamoto Yoshihisa Fukushima Ryu Shimada Koichi Okamoto Takeshi Tsuchiya Keijiro Nozawa Keiji Matsuda Yojiro Hashiguchi | 2016 | World Journal of Gastrointestinal Oncology2016，8，7： | 10 |
| 2 | 腹腔镜下直肠癌全直肠系膜切除术近期疗效及安全性分析显示文摘目的探讨腹腔镜下直肠癌全直肠系膜切除术的安全性和近期疗效。方法回顾性分析我院2013年以来腹腔镜下直肠癌30例患者临床资料。结果所有病例均在腹腔镜下顺利完成手术,手术时间为103~300 min,患者术后1~3 d开始下床活动,肛门排气时间2~8 d,术后住院日7~19 d,术后病理报告切除淋巴结数3~23枚,术后发生切口感染1例,肠梗阻1例,全组无手术死亡病例。结论腹腔镜下直肠癌全直肠系膜切除术安全可行,患者术后恢复快,具有明显的微创优势。 | 李霆 孟翔凌 | 2014 | 安徽医学2014，35，9： | 0 |
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