腹腔镜辅助与开腹手术行右半结肠切除术疗效比较  

Laparoscopic-assisted versus open right hemi-colectomyfor colon carcinoma: a comparative study on short-term &long-term outcomes

作　　者：韩丁培[1] 陆爱国[1] 冯浩[1] 王蒲雄志[1] 曹奇峰[1] 冯波[1] 宗雅萍[1] 张卓[1] 马君俊[1] 郑民华[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院普通外科,上海200025

出　　处：《中国实用外科杂志》2013年第1期77-80,共4页Chinese Journal of Practical Surgery

摘　　要：目的分析并比较腹腔镜辅助与开腹手术行右半结肠切除术的短期及远期疗效。方法将2003年6月至2010年9月在上海交通大学医学院附属瑞金医院行手术治疗的324例右半结肠癌病人纳入研究。其中腹腔镜组(LR组)177例,开腹组(OR组)147例。回顾性分析比较两组临床资料、手术相关资料、术后疗效及长期存活率等的差异。结果两组病人临床资料间的差异无统计学意义;LR组在术后恢复方面均显著优于OR组;术后并发症发生率OR组为22.45%,LR组为12.99%,差异有统计学意义。OR组淋巴结清扫数(11.4±4.1)枚,LR组为(15.2±10.1)枚,差异有统计学意义。两组在肿瘤复发与转移方面的差异无统计学意义。LR组1、3、5年总存活率为97.18%、83.73%及70.37%,OR组为94.56%、77.84%及66.97%,差异无统计学意义。结论腹腔镜辅助右半结肠切除术治疗右半结肠癌安全、有效,短期疗效优于开腹手术,远期疗效与开腹手术相当。Objective To compare the short-time and long-time outcomes between laparoscopic-assisted right hemi-colectomy （LR group） and open right hemi-colectomy （OR group） for colon carcinoma. Methods Between June 2003 and September 2010, 324 patients with colon cancer underwent OR or LR in the same hospital, 177 cases treated by LR and 147 cases by OR. Retrospective analyses the differences between the two groups in clinical data, operative date, complications and follow-up data. Results There are no differences between the two groups in perioperative clinical data; The recovery time was significantly shorter in LR group; The number of all lymph nodes harvestedin LR group was significantly more than OR group （15.2~ 10.1vsl 1.4~4.1）;The incidence of postoperative complications in LR group was significantly less than OR group （12.99%vs22.45%）.Local recurrence and metachronousmetastasis rate in LR group was less than OR group, but the differences were not significant. Cumulative overall survival for all stages at 1, 3 and 5 years of LR group （97.18%, 83.73% and 70.37%） were no significantly different compared to the OR group （94.56%, 77.84% and 66.97%）. Conclusion laparoscopic-assisted right hemi-colectomyfor colon cancer is safe and effective, it is superior to open surgery in short-term outcomes, and equal to open surgery in long-term outcomes.

关 键 词：腹腔镜 右半结肠切除术 结肠癌 开腹手术 

分 类 号：R6[医药卫生—外科学]