腹腔镜与开腹手术治疗结直肠癌的临床疗效观察  

Curative effects of laparoscopic vs.traditional open radical surgery for colorectal cancer

作　　者：李德福[1] 徐国宏[1] 朱静[1] 邹吉 廖志学[1] 邓先锐 岳文杰[1] 胥钱平 李静[1] 

机构地区：[1]四川省眉山市人民医院普外科,620010

出　　处：《腹部外科》2013年第4期265-267,共3页Journal of Abdominal Surgery

摘　　要：目的 对比结直肠癌根治术腹腔镜与开腹手术临床疗效.方法对2010年1月至2012年6月间进行结直肠癌腹腔镜手术患者42例、开腹手术45例患者的临床资料进行分析,比较两组手术时间、术中出血量、术后住院时间、清扫淋巴结总数、术后肠道恢复时间等情况.结果 两组患者手术时间、切除肠管长度、清扫淋巴结数量方面差异无统计学意义（P＞0.05）,腹腔镜组在术中出血量、术后平均住院时间、术后肠道恢复时间、患者术后生存质量上均优于开腹组（P＜0.05）;腹腔镜术后并发症发生率为7.14%（3/42）,开腹组为20.00%（9/45）,两组比较,差异有统计学意义（ P＜0.05）;随访6~12个月,两组患者局部复发率分别为2.38%、6.67%,远处转移率分别为2.38%、4.45%,差异无统计学意义（P＞0.05）.结论 腹腔镜结直肠癌根治术安全可行,手术解剖清晰,具有微创、安全、住院时间短、术后生存质量高、术后恢复快等优点,值得临床推广应用.Objective To investigate the clinical efficacy and safety of laparoscopie and traditional open radical surgery for patients with colorectal cancer. Methods From January 2010 to December 2012, totally 87 patients with colorectal cancer underwent surgery in our center, involving laparoscopic radical surgery in 42 cases and traditional open radical surgery in 45 cases. The clinical data in both groups and follow-up data were collected and analyzed retrospectively. Results The operative time, lenght of the resected intestinal segment, and the number of the dissected lymph nodes had no statistically significant difference between two groups （P〈0.05）. The volume of intraoperative blood loss in laparoscopic radical surgery group was significantly less than that in open radical surgery group. Furthermore, duration of postoperative analgesia, postoperative intestinal function recovery time and mean hospital stay were shorter in laparoscopic radical surgery group than in open radical surgery group （P〈0. 05）. The postoperative complication rate was 7. 14% （3/42） in laparoscopic radical surgery group, which was significantly lower than 20. 00% （9/45） in open radical surgery group （P〈0. 05）. During the follow-up period of 6 to 12 months, no statistically significant difference was found in local recurrence （2. 38% vs. 6. 67%） and metastasis rate （2. 38% vs. 4. 45%） （P〈0. 05） between laparoscopic radical surgery group and open radical surgery group. Conclusion The laparoseopic radical resection of colorectal carcinoma presents some benefits, including minimal invasion to tissue, safety, faster recovery and shorter period of hospitalization, as well as better postoperative quality of life. Although these, no significant difference can be found in radical resection to tumor tissue, local recurrence rate and long-term survival rate.

关 键 词：结肠肿瘤 腹腔镜 疗效比较研究 

分 类 号：R735.37[医药卫生—肿瘤]