腹腔镜与开腹结直肠癌根治术对胃肠功能及远期预后的比较分析  

Comparative analysis on the gastrointestinal function and long-term outcomes between laparoscopic and open radical resection for colorectal cancer

作　　者：韩刚[1] 龚航军[1] 王以东[1] 曹羽[1] 付晓伶[1] 

机构地区：[1]上海中医药大学附属曙光医院,上海201203

出　　处：《腹腔镜外科杂志》2016年第6期433-436,共4页Journal of Laparoscopic Surgery

基　　金：国家自然科学基金青年科学基金项目(编号:81403360)

摘　　要：目的：探讨腹腔镜下结直肠癌根治术的临床疗效、术后胃肠功能及远期预后。方法：回顾分析2005年1月至2011年6月106例结直肠癌根治术的临床及随访资料,根据随机数字表法,将患者分为腹腔镜组（n=61）与开腹组（n=45）。对比分析两组患者手术相关指标、胃肠功能恢复情况、并发症及术后1年、3年生存率。结果：两组淋巴结清扫数量、远切缘距离差异无统计学意义（P〉0.05）。与开腹组相比,腹腔镜组手术时间明显延长,术中出血量、肠鸣音恢复时间明显缩短（t=13.086,17.679,11.771,P〈0.05）,两组近期、远期并发症差异均无统计学意义（P〉0.05）。腹腔镜组与开腹组术后平均生存时间分别为70.2个月（95%CI：66.3~73.8）与63.5个月（95%CI：59.3-67.6）,差异无统计学意义（χ~2=2.45,P〉0.05）;腹腔镜组Ⅲ期患者术后生存时间显著长于开腹组（χ~2=3.92,P〈0.05）。结论：腹腔镜下结直肠癌根治术在肿瘤的根治性、远期生存率方面与开腹手术相当,但可促进胃肠道功能恢复,延长Ⅲ期患者术后生存时间。Objective： To explore the clinical effect of laparoscopic radical resection for colorectal cancer,and its impact on gastrointestinal function and long-term prognosis. Methods： Clinical and follow-up data of 106 patients with colorectal cancer undergoing radical resection were retrospectively analyzed. According to the random number table,patients were divided into laparoscopic group（ n= 61） and open group（ n = 45）. Operation related indexes,recovery of gastrointestinal function,short-term and long-term complications,and 1-year,3-year survival rate were compared between the two groups. Results： There was no significant difference in number of harvested lymph nodes,distance between distal margin and tumor between the two groups（ P〈0. 05）. Compared with open group,the operation time of laparoscopic group was significantly increased,intraoperatve blood loss and recovery time of bowel sound were decreased（ t = 13. 086,17. 679,11. 771,P〈0. 05）. There was no significant difference in the short- and long-term complications between two groups（ P〈0. 05）. There was no significant difference on the average survival time after surgery in laparoscopy group and open group（ 70. 2 months,95% CI： 66. 3-73. 8 vs. 63. 5 months,95% CI： 59. 3-67. 6,χ-2= 2. 45,P〈0. 05）. For the phase Ⅲ patients,the postoperative survival time of laparoscopic group was longer than that of open group（ χ-2= 3. 92,P〈0. 05）. Conclusions： Laparoscopic radical resection of colorectal cancer has similar effect on radical tumor removal and long-term survival rate with open surgery,and can promote recovery of gastrointestinal function,prolong the postoperative survival time of phase Ⅲ patients.

关 键 词：结直肠肿瘤 腹腔镜检查 剖腹术 胃肠功能 远期预后 对比研究 

分 类 号：R735.34[医药卫生—肿瘤]