腹腔镜和开腹肝切除治疗结直肠癌肝转移的临床观察  

Clinical study of laparoscopic and open hepatectomy for liver metastases from colorectal cancer

作　　者：张玉琦 周晗 高文涛[2] ZHANG Yu-qi;ZHOU Han;GAO Wen-tao(General Surgery of Caoxian County Hospital in Shandong Province,Shandong 274400,China;Clinical Department,Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]山东省曹县县立医院普外科,山东菏泽274400 [2]南京医科大学基础系,江苏南京210029

出　　处：《中国现代普通外科进展》2018年第12期960-963,共4页Chinese Journal of Current Advances in General Surgery

摘　　要：目的:探讨采取腹腔镜肝切除及开腹肝切除治疗结直肠癌肝转移患者的临床疗效。方法:2015年1月—2016年12月66例结直肠癌肝转移患者随机分为对照组(开腹肝切除术治疗)与观察组(腹腔镜肝切除术治疗)各33例,对两组患者的手术相关指标、并发症发生情况及随访情况进行观察。结果:观察组手术时间略长于对照组(P>0.05),术中出血量、术后平均住院时间两组差异有统计学意义(P <0.05);并发症发生率、术前肝功能指标两组差异无统计学意义(P>0.05),术后3d时,观察组的总胆红素低于对照组(P <0.05),其余指标差异统计学意义(P>0.05);观察组平均随访31(6～42)月,对照组平均随访23.5(7～43)月,其中观察组复发20例(60.6%),有2例(6.1%)分别于随访至22个月、30个月时死亡。对照组复发23例(69.7%),有2例(6.1%)在随访至第20个月、18个月时死亡,两组复发率、死亡率,差异无统计学意义(P>0.05)。结论:结直肠癌肝转移采取腹腔镜切除治疗,平均住院时间、术中出血量及术后肝功能恢复优于开腹切除术,在长期生存率及肿瘤复发上,两种手术无太大差别。Objective:To investigate the clinical efficacy of laparoscopic hepatectomy and open hepatectomy for colorectal cancer patients with liver metastases.Methods:66 cases of liver metastases from colorectal cancer received in our hospital from January 2015 to December 2016 were randomly divided into control group(n=33,open hepatectomy)and observation group(n=33,laparoscopic hepatectomy),and the related indexes,complications and follow-up of the two groups of patients were observed.Results:The operation time of the observation group was slightly longer than that of the control group,the difference was not statistically significant(P>0.05).The amount of bleeding during the operation was less than that of the control group,the difference was statistically significant(P<0.05).The average length of stay in the observation group was less than that in the control group(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).There was no statistical difference between the two groups before operation(P>0.05).The total bilirubin in the observation group was lower than that of the control group at 3d after operation(P<0.05),and the other indexes were similar,and there was no statistical significance between the groups(P>0.05).The average follow-up of the observation group was 31(6~42)months,the average follow-up of the control group was 23.5(7~43)months,the two groups had no significant difference(P>0.05).During the follow-up period,in the observation group,20 cases(60.6%)recurred,in the control group,13 cases(39.4%)did not relapse,23 cases(69.7%)recurred,and 10 cases(30.3%)did not relapse.In the observation group,2 cases(6.1%)died and died at 22 months and 30 months respectively.In the control group,2 cases(6.1%)died at 20 months and 18 months,and the recurrence rate and mortality rate of the two groups were statistically significant(P>0.05).Conclusion:Laparoscopic dry resection for the treatment of liver metastasis of colorectal cancer,the average number of days of hospitali

关 键 词：结直肠癌肝转移 开腹肝切除术 并发症 腹腔镜肝切除术 

分 类 号：R735.35[医药卫生—肿瘤] R735.37[医药卫生—临床医学]