腹腔镜与同期开腹直肠癌切除术后长期肿瘤学结果的对比研究  

Comparison of long-term oncological outcomes of laparoscopic and open resection of rectal cancer

作　　者：钟秉政[1] 刘峰[1] 余江[1] 梁耀泽[1] 赵丽瑛[1] 牟廷裕[1] 胡彦锋[1] 李国新[1] 

机构地区：[1]南方医科大学南方医院普外科,广东广州510515

出　　处：《南方医科大学学报》2012年第5期664-668,共5页Journal of Southern Medical University

基　　金：广东省自然科学基金(07300474);广州科技计划项目(2008A030201017)

摘　　要：目的比较腹腔镜及同期开腹直肠癌切除术术后的长期肿瘤学结果。方法回顾性分析南方医院自2003年1月~2008年12月收治的514例病人的临床随访资料,对186例腹腔镜组和328例开腹组病人术后复发类型及长期生存结果进行了比较。结果两组病人的中位随访时间为（48.54±28.76）月,两组间远处转移（3.9%vs 5.5%;P=0.284）、5年累积总生存率（69.5%vs 61.7%;P=0.085）和5年无病生存率（67.7%vs 60.7%;P=0.110）的差异无统计学意义。IV期病例中腹腔镜组5年累计总生存率和5年无进展生存率均高于开腹组（P〈0.05）。结论腹腔镜直肠癌切除术可以获得不劣于开腹手术的长期肿瘤学结果。Objective To compare the long-term oncological outcomes of laparoscopic and open resection of rectal cancers.Methods Between January,2003 and December,2008,514 patients with rectal cancer were admitted in our hospital,among whom 186 underwent laparoscopic tumor resection and 238 received open radical resection of the tumors.The long-term survival of the patients and the recurrence pattern were compared between the two groups.Results The median follow-up of the patients was 48.54±28.76 months.No significant differences were found between the two groups in the local recurrence rate（3.9% vs 5.5%,P=0.284）,5-year overall survival（69.4% vs 61.3%,P=0.067）,or the 5-year disease-free survival rates（67.7% vs 60.7%,P=0.110）.Both the 5-year overall survival and progression-free survival of the patients in stage IV were better in the laparoscopic group than in the open surgery group（P0.05）.Conclusion Laparoscopic resection of rectal cancer can achieve long-term oncological outcomes comparable to those of conventional open surgery.

关 键 词：直肠癌 腹腔镜手术 开腹手术 

分 类 号：R735.3[医药卫生—肿瘤]