腹腔镜与开腹完整结肠系膜切除术的疗效对比研究  

Clinical comparison of laparoscopic and open complete mesocolic excision for colon cancer

作　　者：吴建林[1] 刘志民[1] 葛宏[1] 石光锋 徐其佐[1] 张成才[1] 祝林[1] 曹策[1] 

机构地区：[1]滨州医学院附属淄博市中心医院,淄博市腹腔镜外科工程技术研究中心,山东淄博255036

出　　处：《腹腔镜外科杂志》2014年第8期577-579,共3页Journal of Laparoscopic Surgery

摘　　要：目的:探讨腹腔镜与开腹结肠癌完整结肠系膜切除术(complete mesocolic excision,CME)患者术后恢复、手术质量及中期疗效的差异。方法:收集2010年12月至2013年9月124例结肠癌CME手术患者的临床资料。其中腹腔镜组66例,开腹组58例,对比分析两组患者术后恢复、肿瘤根治性、术后感染发生率及中期复发率等指标。结果:腹腔镜组在术中出血量、术后排气时间、术后下床时间、切口感染率方面均优于开腹手术组(P<0.05),两组患者近端切缘、远端切缘长度、淋巴结清扫数量及手术时间差异均无统计学意义(P>0.05)。113例(91.1%)患者获得术后随访,中位随访时间18个月,腹腔镜组与开腹组局部复发率分别为4.55%(3/66)与5.17%(3/58),两组相比差异无统计学意义(P>0.05)。结论:腹腔镜结肠癌CME手术较开腹手术可显著缩短患者术后恢复时间,且能达到与开腹手术相同的肿瘤根治范围,具有广阔的应用前景。Objective：To explore the differences of postoperative recovery, surgical quality and mid-term efficacy between lapa- roscopic and open complete mesocolic excision （CME） in the treatment of colon cancer. Methods：During Dec. 2010 to Sep. 2013,124 cases of colon cancer were included, of which 66 patients were assigned to laparoscopic CME and 58 to open procedure,and postopera- tive recovery, the degree of cancer radical resection, postoperative infection, and mid-term recurrence were compared between the two groups. Results：One hundred and thirteen patients （91.1% ） of 124 patients received follow-up, with a median time of 18 months. The differences of proximal and distal surgical margin length, number of lymph nodes dissection, surgical time and local tumor recurrence rate （4.55% vs. 5.17% ） were not statistically significant （P 〉 0.05 ） ,but laparoscopic C ME were better than the laparotomy in the blood loss, time of postoperative flatus, ambulation time, incision infection rates （ P 〈 0.05 ）. Conclusions ： Compared to open CME,laparoscopic CME which can significantly shorten the time of postoperative recovery and achieve the same range of cancer radical resection,has a broad application prospect.

关 键 词：结肠肿瘤 腹腔镜检查 剖腹术 完整结肠系膜切除术 疗效比较研究 

分 类 号：R735.34[医药卫生—肿瘤]