腹腔镜辅助与开腹全结肠切除术的临床疗效比较  

Laparoscopy-assisted versus open total colectomy:Comparison of clinical outcomes

作　　者：崔建[1] 张建立[2] 江秀丽[3] 

机构地区：[1]青岛大学医学院附属医院乳腺外科,青岛医学硕士266003 [2]青岛大学医学院附属医院普通外科,青岛266003 [3]青岛大学医学院附属医院营养科,青岛266003

出　　处：《医学研究生学报》2012年第2期158-161,共4页Journal of Medical Postgraduates

摘　　要：目的随着微创技术的广泛应用,腹腔镜全结肠切除术已应用于治疗多种结直肠疾病。文中比较腹腔镜辅助与开腹全结肠切除术的临床疗效,探讨腹腔镜辅助全结肠切除术的安全性和可行性。方法回顾性分析23例全结肠切除术的临床资料,分为开腹手术组(l2例)和腹腔镜手术组(11例),比较2组患者的一般情况、手术情况、术后情况以及疗效评价。结果 22例患者顺利完成手术,无相关并发症,1例结肠多原发癌患者中转开腹。腹腔镜组的失血量、术后住院天数和切口长度均少于或小于开腹组(P<0.05),排气时间和进食后排便次数与开腹组无明显差异(P>0.05),腹腔镜组手术时间相比开腹手术组延长105 min(P<0.05)。术后随访6～18个月,患者均未见转移及复发,排便次数2～5次/d。结论腹腔镜辅助全结肠切除术安全可行,近期疗效良好。Objective With the extensive application of minimally invasive techniques, laparoscopy-assisted total colectomy （LATC） has been used to treat a variety of colorectal diseases. The article is to compare the clinical outcome of LATC with that of open total eolectomy, and investigate the safety and feasibility of LATC. Methods We retrospectively analyzed 12 cases of open total co- lectomy and 11 cases of LATC, and compared the demographics, peri- and post-operative data, and treatment outcomes between the two groups. Results Total colectomy was successfully accomplished in 22 of the cases without severe complications, but changed to open abdominal surgery in the other 1 case of multiple colonic cancer. Compared with the patients that underwent open surgery, the LATC group showed significantly less blood loss, shorter incision and postoperative hospital stay （P 〈 0.05 ）, but 105 min longer oper- ative time （ P 〈 0.05 ）. There were no significant differences in postoperative recovery of bowel function and the average stool frequency between the two groups （P 〉 0.05 ）. During the 6 - 18 months follow-up, no local recurrence or distant metastasis was found, and the stool frequency was 2 -5 times per day. Conclusion Laparocopy-assisted total coleetomy is an applicable option for its safety and desirable short-term outcome.

关 键 词：腹腔镜手术 全结肠切除术 家族性腺瘤性息肉病 结肠肿瘤 

分 类 号：R656.9[医药卫生—外科学]