腹腔镜手术与开腹手术在结直肠癌根治术中临床疗效的对比研究  

Which is Better in Radical Resection of Colorectal Carcinoma,Laproscopic Operation or Open Surgery?

作　　者：杨钰[1] 姜春玉[2] 

机构地区：[1]齐齐哈尔医学院附属第三医院普外一科,黑龙江省齐齐哈尔市161000 [2]齐齐哈尔医学院附属第三医院心内一科,黑龙江省齐齐哈尔市161000

出　　处：《中国全科医学》2013年第17期1990-1993,共4页Chinese General Practice

摘　　要：目的对比腹腔镜手术与开腹手术在结肠癌根治术中的临床疗效。方法选择2006年7月—2012年6月由我组手术医生完成的结直肠癌根治术患者376例,根据手术方式将患者分为腹腔镜手术组196例和开腹手术组180例。对比两组患者手术情况及肿瘤情况,肠功能恢复时间及住院时间,并发症及死亡情况,随访情况等。结果开腹手术组患者中转开腹率为9.7%(21/180)。两组患者手术时间、术中出血量、术后镇痛药物使用率、切除淋巴结数目比较,差异均有统计学意义(P<0.05);排气时间、排便时间、进食时间及住院时间比较,差异均有统计学意义(P<0.05);切口感染发生率比较,差异有统计学意义(P<0.05);两组中TNMⅡ期患者(χ2=0.682,P=0.641)、TNMⅢ期患者(χ2=0.541,P=0.713)累积生存率比较,差异均无统计学意义。结论腹腔镜手术在结直肠癌根治术中安全有效,与传统开腹手术相比,可以减轻患者痛苦,降低患者术后切口感染发生率,缩短患者肠功能恢复时间,值得临床推广应用。Objective To compare the clinical effect of lanroscopic operation with that of open surgery in radical resec-tion of colorectal carcinoma. Methods A total of 376 patients having finished colorectal cancer surgeries from July 2006 to June 2012 were divided, according to surgical approaches, into groups lanroscopic operation （n = 196）, open surgery （n = 180）. The surgical conditions, tumors, intestinal function recovery time, hospital stay, complications, death, follow - up and so on were compared between the two groups. Results The open surgery rate was 9.7% （21/180）. There was significant difference between the two groups in surgical time, blood loss, cases using analgesic drugs after operation, number of resected lymph nodes, exhaustion time, defecation time, time of food intake, hospital stay, incidence of wound infection （P 〈 0. 05）. There was no significant difference in cumulative survival rate between patients at TNM Ⅱ stage （ X^2 = 0. 682, P = 0. 641 ） and at TNM Ⅲ stage （ X^2 = 0. 541, P = 0. 713） in the two groups. Conehtsion Laproscopic operation, safe and effective in radical resec-tion of colorectal carcinoma and reducing patients＇pains and incidence of wound infection and shortening recovery time of intestinal function, is worth generalizing and applying.

关 键 词：结直肠肿瘤 腹腔镜 外科手术 治疗结果 术后并发症 

分 类 号：R735.35[医药卫生—肿瘤] R735.37[医药卫生—临床医学]