腹腔镜与开腹全结肠系膜切除手术治疗右半结肠癌的疗效比较  

Comparison of the effects of laparoscope and open complete mesocolic excision in the treatment of right colon cancer

作　　者：陆峰 王刚[1] 周井荣 邱磊[1] 杨修伟 苗永昌[1] Lu Feng;Wang Gang;Zhou Jingrong;Qiu Lei;Yang Xiuwei;Miao Yongchang(Department of Gastrointestinal Surgery,the Second People s Hospital of Lianyungang,Lianyungang,Jiangsu 222000,China)

机构地区：[1]连云港市第二人民医院胃肠外科,江苏省222000

出　　处：《中国基层医药》2019年第22期2716-2720,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨腹腔镜与开腹全结肠系膜切除(CME)治疗右半结肠癌疗效的差异.方法采用回顾性病例对照研究,收集2014年1月至2017年11月连云港市第二人民医院胃肠外科收治的右半结肠癌CME手术患者139例的临床资料,其中腹腔镜手术55例,开腹手术84例,比较两组术后恢复情况及肿瘤学疗效.结果腹腔镜组的手术时间[(172.8±25.9)min]比开腹组手术时间[(142.3±20.6)min]长(t=7.387,P<0.05),但是腹腔镜组的术中出血量[(111.6±36.7)mL]较开腹组[(150.1±61.1)mL]少(t=4.017,P<0.05),两组术中清扫淋巴结总数差异无统计学意义(P>0.05).腹腔镜组术后排气时间、术后进食流质时间及住院时间均较开腹组短(t=4.695、5.517、4.642,均P<0.05),两组术后并发症发生率差异无统计学意义(P>0.05).两组患者术后3年累积复发转移率、累积生存率、累积无瘤生存率差异均无统计学意义(均P>0.05).结论腹腔镜CME手术治疗右半结肠癌创伤小,恢复快,且具有相同肿瘤根治性.Objective To compare the effects of laparoscope and open complete mesocolic excision(CME)in the treatment of right colon cancer.Methods The retrospective case-control study was adopted.The clinical data of 139 patients with right colon cancer who underwent CME at the Second People's Hospital of Lianyungang from January 2014 to November 2017 were collected.The patients were divided into laparoscopy group(55 cases)and open group(84 cases).The postoperative recovery and oncology efficacy were compared.Results The operation time in the laparoscopy group[(172.8±25.9)min]was longer than that in the open group[(142.3±20.6)min](t=7.387,P<0.05),but the blood loss of the laparoscopy group[(111.6±36.7)mL]was less than that in the open group[(150.1±61.1)mL](t=4.017,P<0.05).There was no statistically significant difference in numbers of lymph nodes harvested.Compared with open group,there were advantages in the laparoscopy group such as less anal exhaust time,less postoperative eating liquid diet time and shorter hospitalization time,the differences were statistically significant(t=4.695,5.517,4.642,all P<0.05).There was no statistically significant difference in postoperative complication rate(P>0.05).There were no statistically significant differences in the cumulative recurrence rate,cumulative survival rate and cumulative survival rate between the two groups after 3 years(all P>0.05).Conclusion Laparoscopic CME is minimally invasive and quick recovery,and laparoscopic CME has the same oncologic clearance effects,and is worthy of clinical application.

关 键 词：结肠肿瘤 外科手术 结肠系膜 腹腔镜 手术后并发症 疗效比较研究 

分 类 号：R73[医药卫生—肿瘤]