腹腔镜与开腹全结肠切除术治疗家族性息肉病的疗效比较  

Laparoscopic total colectomy versus open colectomy for familial adenomatous polyposis

作　　者：曾长青[1,2] 黄良祥[1,2] 郑羽[1,2] 刘进生[1,2] 陈林昊[1,2] 黄海啸[1,2] 

机构地区：[1]福建医科大学省立临床医学院 [2]福建省立医院胃肠外科,福建福州350001

出　　处：《中国普通外科杂志》2012年第12期1558-1561,共4页China Journal of General Surgery

摘　　要：目的:比较腹腔镜下全结肠切除术和传统开腹术在治疗家族性息肉病的安全性与有效性。方法:回顾性分析2003年1月—2011年1月间收治的家族性息肉病患者56例的临床资料,按术式将患者分为腹腔镜组(31例)和传统开腹组(25例),比较两组术前、术中及术后情况。结果:两组术前一般资料具有可比性(P>0.05);两组术中失血量无明显差异,均无输血(均P>0.05),腹腔镜组平均手术时间长于开腹组(330 min vs.160 min)(P<0.05);术后,两组除胃肠道恢复时间无统计学差异外(P>0.05),与开腹组比较,腹腔镜组术后并发症发生率(0 vs.24%),止痛药使用例数(0 vs.6),平均住院时间(8 d vs.14 d)及术后前3天平均引流量(30 mL vs.100 mL)均明显减少(均P<0.05);术后3个月,腹腔镜组未见复发,而开腹组3例复发(P<0.05)。结论:腹腔镜下全结肠切除术可以安全有效地治疗家族性息肉病,且较开腹术在生活质量和远期疗效方面存在优势。Objective： To compare the safety and efficacy oflaparoscopic total colectomy and open resection in treatment of familial adenomatous polyposis （FAP）. Methods： The clinical data of 56 patients with FAP admitted from January 2003 to January 2011 were retrospectively analyzed. Patients were divided, according to the procedures, into laparoscopic group （31 cases） and conventional open surgery group （25 cases）. The pre-, intra- and Fostoperative d-_ta between the two groups were compared. Results： The general data between the two groups before surgery were comparable （P〉0.05）. There was no significant difference in intraoperative blood loss between the two groups, and no transfusion was required in any of the groups （both P〉0.05）. However, laparoscopic procedure took a longer operative time than that in open surgery group （P〈0.05）. In comparison with open of postoperative complications （0 vs. 24%）, number of patients of postoperative hospital stay （8 d vs. 14 d）, and average daily 100 mL） were all significantly reduced in laparoscopic group （all surgery group after operation, the incidence needing analgesics （0 vs. 6）, average length volume of abdominal drainage （30 mL vs. P〈0.0S）, but there was no difference in time to recovery of gastrointestinal function （P〉0.05）. At three months after operation, no recurrence was noted in laparoscopic group but it occurred in 3 cases in open surgery group （P〈0.05）. Conclusion： Laparoscopic total colectomy is safe and effective for treatment of FAP, and it is superior to open surgery in improving patients＇ quality of life and long term outcomes.

关 键 词：腺瘤息肉病 结肠 结肠切除术 腹腔镜 对比研究 

分 类 号：R656.9[医药卫生—外科学]