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目的探讨老年胃癌围手术期处理的有关问题及适当的手术方式。方法回顾性分析2000年1月-2009年4月收治的60例65岁以上老年胃癌患者的术前准备、手术方式选择及术后处理。结果60例中52例行胃癌切除术,切除率为86.7%。其中行根治性切除术38例(63.3%),姑息性切除14例(23.3%);行胃空肠吻合术5例(8.3%);行探查取活检者3例(5.0%)。45例(75.0%)术前并存其他疾病。手术前有并存疾病者,术后并发症的发生率为33.3%(15/45);术前无并存疾病者,术后并发症的发生率为6.7%(1/15)。结论老年胃癌患者术前营养状况的改善以及合并症的处理是围手术期的重要环节,手术方式应强调个体化原则。
Objective To investigate the perioperative management of elderly patients with gastric cancer and the appropriate surgical approach. Methods A retrospective analysis of 60 cases of elderly patients over 65 years old admitted to our hospital from January 2000 to April 2009 were performed preoperative preparation, operation selection and postoperative management. Results In 60 cases of 52 cases of gastric cancer resection, resection rate was 86.7%. There were 38 cases (63.3%) underwent radical resection and 14 cases (23.3%) underwent palliative resection. Gastro jejunostomy was performed in 5 cases (8.3%). Surgical exploration was performed in 3 cases (5.0%). 45 cases (75.0%) preoperative co-exist other diseases. Preoperative coexisting disease, the incidence of postoperative complications was 33.3% (15/45); preoperative co-morbidity, the incidence of postoperative complications was 6.7% (1/15). Conclusion The improvement of preoperative nutritional status and complications in elderly patients with gastric cancer is an important part of perioperative period. The principle of individualization should be emphasized in the surgical procedure.