腹腔镜手术对直肠癌患者腹腔及肠腔癌细胞脱落和生存期的影响  

Effect of laparoscopy on the intraperitoneal and intraluminal exfoliated cancer cells and survival time in patients with rectal cancer

作　　者：赵耀[1] 唐晓军[1] 张逖[1] 

机构地区：[1]南京医科大学附属淮安第一医院胃肠外科,江苏淮安223300

出　　处：《胃肠病学和肝病学杂志》2016年第12期1459-1462,共4页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的探讨腹腔镜手术对直肠癌患者腹腔及肠腔癌细胞脱落和生存期的影响。方法收集2013年1月-2015年6月南京医科大学附属淮安第一医院收治的136例手术治疗的直肠癌患者，其中腹腔镜手术（腹腔镜组）74例，开腹手术（开腹组）62例。比较两组患者肿瘤切除前后脱落癌细胞阳性率、术后复发率和总生存率。结果两组患者肿瘤切除前腹腔、肠腔脱落癌细胞阳性率比较，差异无统计学意义（P均〉0．05）。两组患者肿瘤切除后的腹腔、肠腔脱落癌细胞阳性率较肿瘤切除前均升高，但只有开腹组肠腔脱落癌细胞阳性率差异有统计学意义（30．65％／）vs 11．29％，P〈0．05）。腹腔镜组肿瘤切除后的腹腔、肠腔脱落癌细胞阳性率均低于开腹组，其中肠腔脱落癌细胞阳性率差异有统计学意义（16．22％口s30．65％，P〈0．05）。术后随访8．5～47．9个月，随访率为88．2％。腹腔镜组1年、3年总生存率分别为93．2％、77．5％，开腹组1年、3年总生存率分别为92．7％、71．3％，差异无统计学意义（P〉0．05）。两组患者的局部复发率和远处转移率比较，差异也无统计学意义（P均〉0．05）。结论腹腔镜技术并没有增加腹腔、肠腔癌细胞脱落和复发转移的可能性，术后近期生存率与玎腹手术相当。Objective To investigate the effect of laparoscopy on the intraperitoneal and intraluminal exfoliated canc- er cells and survival time in patients with rectal cancer. Methods One hundred and thirty-six cases of rectal cancer pa- tients who underwent radical surgery from Jan. 2013 to Jun. 2015 were included. They were divided into laparoscopic group （n = 74） and open surgery group （ n = 62）. The positive rate of exfoliated cancer cells, recurrence and overall survival rate between the two groups were compared. Results There was no difference in the positive rate of intraperito- neal and intraluminal exfoliated cancer cells before cancer resection between the two groups （P 〉 0.05 ）. The positive rate of intraperitoneal and intraluminal exfoliated cancer cells after cancer resection in the two groups was higher than be- fore cancer resection, but the difference of intraluminal exfoliated cancer cells between before and after cancer resection in the laparoscopic group was statistical （30.65% vs 11.29% , P 〈 0.05）. The positive rate of intraperitoneal and in- traluminal exfoliated cancer ceils after cancer resection in the laparoscopie group was higher than those in the open sur- gery group, but the difference of intraluminal exfoliated cancer cells between the two groups was statistical （16.22% vs 30.65% , P 〈 0.05 ）. The follow-up ranged from 8.5 to 47.9 months and follow-up rate was 88.2%. The 1- and 3-year overall survival rate in the laparoscopic group were 93.2% ,77.5% ,and those in the open surgery group were 92.7% , 71.3%. No difference was found in the survival time between the two groups （P 〉 0. 05）. There was no statistical difference in the local recurrence and distant metastasis between the two groups （P 〉 0.05）. Conclusion Laparoscopy does not increase the positive rate of intraperitoneal and intraluminal disseminated cancer cells, the recurrence, metasta- sis, and results in similar survival in patients with rectal cancer as compared with open surgery.

关 键 词：腹腔镜 直肠癌 脱落癌细胞 生存期 

分 类 号：R735.37[医药卫生—肿瘤]