腹腔镜与结肠镜微创术双联疗法治疗结直肠肿瘤的疗效分析与安全性评价  

Effectiveness and safety of combining laparoscopy and colonoscopy in the surgical treatment of colorectal cancer

作　　者：张志云[1] 雷新益 吉祖进 杨勇[1] 蒋学军[1] 

机构地区：[1]湖北医药学院附属东风总医院结直肠肛门外科,湖北十堰431017

出　　处：《结直肠肛门外科》2016年第5期495-498,共4页Journal of Colorectal & Anal Surgery

摘　　要：目的 探讨腹腔镜与结肠镜微创术双联疗法治疗结直肠肿瘤的临床疗效及安全性。方法 选取2013年3月-2015年3月本院收治的120例结直肠肿瘤患者为研究对象,随机分为观察组和对照组（每组各60例）。对照组采取传统开腹手术治疗,观察组采取腹腔镜与结肠镜微创术双联法治疗。比较两组患者术期相关指标、术后恢复情况、术后并发症情况、后期复发和转移情况。结果 观察组手术耗时（112.37±6.25）min、术中出血量（64.77±16.38）mL,对照组分别为（134.66±7.19）min、（115.32±31.78）mL,差异均有统计学意义（P〈0.05）,观察组术后引流时间、引流量、术后下床时间、住院时间分别为（5.32±0.56）d、（95.43±35.59）mL、（3.82±1.53）d、（7.05±1.12）d均优于对照组,差异均有统计学意义（P〈0.05）。观察组并发症总发生率显著低于对照组,差异有统计学意义（P〈0.05）。观察组术后12个月的恶性肿瘤复发率和转移率分别为8.00%（2/25）、4.00%（1/25）均分别显著低于对照组,差异均有统计学意义（P〈0.05）。结论 在结直肠肿瘤治疗中,腹腔镜与结肠镜微创术双联疗法较传统开腹手术相比,前者总体临床效果更优。Objective To investigate the effectiveness and safety of combing laparoscopy and colonoscopy in minimally invasive surgery in patients with colorectal cancer. Methods 120 patients with colorectal cancer were recruited from our hospital between March 2013 and March 2015. They were randomly assigned into treatment group and control group. The control group received the traditional open surgery, and the experimental group received combined laparoseopic and colonoscopic minimally invasive surgery. The two groups were compared in terms of the following parameters： the operation time, intraoperative bleeding, the first anal exhaust time, postopera- tive defecation time, postoperative drainage, postoperative drainage time, postoperative bed time, hospitalization time, postoperative complications, the incidence of recurrence and metastasis. Results Operation time [ （112.37±6.25） mini and the amount of bleeding [ （64.77±16.38） mL] were significantly lower in the treatment group than in the control group [ （134.66±7.19） min, and （115±31.78） mL, respectively ]. Drainage time, amount of drainage, postoperative bed time, hospitalization time [ （5.32±0.56） d, （95.43±35.59） mL, （3.82±1.53） d, （7.05± 1.12） d, respectively ] were also significantly better in the treatment than in the control group （all P〈0.05 ）. The overall incidence of complications in the treatment group was significantly lower than in the control group （P〈0.05）. Metastasis and re- currence rate after 12 months were 8% （2/25） and 4% （1/25）, respectively, in the treatment group, which were significantly lower than in the control group （P〈0.05）. Conclusion Combination of laparoscopic and colonoscopic minimally invasive surgery has better post- operative recovery, favorable safety, and fewer complication and recurrence rate in the treatment of colorectal cancer

关 键 词：腹腔镜 结肠镜 结直肠肿瘤 疗效 安全性 

分 类 号：R735.34[医药卫生—肿瘤]