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目的:探讨70岁以上高龄结直肠癌的临床特点及外科治疗原则。方法:回顾性分析38例经手术和病理证实的70岁以上高龄结直肠癌患者临床资料。结果:所有38例患者均行手术治疗,其中27例(71·1%)属根治性切除,7例姑息性切除,4例行结肠造口术。总切除率为89·5%。无手术死亡病例。获随访23例(60·5%)。总的2年和5年生存率分别为90·1%和51·4%。结论:对高龄结直肠癌患者应采取个体化治疗方案,原则是尽可能行肿瘤根治性切除,根治性切除仍是目前治疗高龄结直肠癌患者行之有效的方法。通过手术预防或解除梗阻,以提高患者生活质量和生存率。依靠现代外科手术技术的进步,围手术期的正确处理以及现代营养支持治疗,可以有效提高手术成功率、降低死亡率和合并症的发生。
Objective: To investigate the clinical features and surgical treatment of colorectal cancer in patients over 70 years of age. Methods: The clinical data of 38 patients with colorectal cancer over the age of 70 confirmed by operation and pathology were retrospectively analyzed. RESULTS: All 38 patients underwent surgical treatment, of whom 27 (71.1%) underwent radical resection, 7 had palliative resection and 4 had colostomy. The total resection rate was 89.5%. No surgical deaths. Follow-up was 23 cases (60.5%). The overall 2-year and 5-year survival rates were 90.1% and 51.4% respectively. Conclusion: Individualized treatment for elderly patients with colorectal cancer should be adopted. The principle is to conduct radical resection as far as possible. Radical resection is still an effective method for treating elderly patients with colorectal cancer. Surgery to prevent or relieve obstruction to improve patient quality of life and survival. Relying on the progress of modern surgical techniques, the correct perioperative management and modern nutritional support and treatment, can effectively improve the success rate of surgery and reduce mortality and comorbidities.