三种手术方式用于结直肠癌肝转移病灶切除的疗效及安全性比较  

Comparison of efficacy and safety of three surgical methods for resection of liver metastases of colorectal cancer

作　　者：赵豹[1] 董磊[1] 孙礼山 夏猛[1] Zhao Bao;Dong Lei;Sun Lishan;Xia Meng(Department of Gastrointestinal Surgery,General Hospital of North Anhui Coal Power Group,Anhui 234000,China)

机构地区：[1]皖北煤电集团总医院胃肠外科,234000

出　　处：《中华普外科手术学杂志（电子版）》2020年第4期366-369,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：安徽省卫生和计划生育委员会项目编号:2016QK050。

摘　　要：目的比较三种手术方式用于结直肠癌肝转移病灶切除的疗效及安全性。方法回顾性分析2014年1月至2017年1月接受手术治疗的108例结直肠癌肝转移患者病例资料,根据术式不同分为三组,将接受3D腹腔镜辅助肝转移病灶切除术的35例患者纳入3D组,将受2D腹腔镜辅助肝转移病灶切除术的33例患者纳入2D组,将接受传统开腹肝转移病灶切除术的40例患者纳入开腹组。采用SPSS 23.0统计分析软件,符合正态分布的手术相关指标以(■±s)表示,多组间均值比较采用单因素方差分析,多组间两两比较采用LSD检验;并发症、生存率以率表示,采用χ^2检验,P<0.05为差异有统计学意义。结果手术时间、术中出血量、肛门排气时间、住院时间比较,开腹组>2D组>3D组,差异均有统计学意义(P<0.05);三组术后1年、2年、3年生存率比较,差异均无统计学意义(P>0.05)。3D组并发症总发生率(11.4%)与2D组(9.1%)比较,差异无统计学意义(P>0.05);开腹组并发症发生率(30.0%)比3D组、2D组高,差异均有统计学意义(P<0.05)。结论3D腹腔镜用于结直肠癌肝转移病灶切除可减少手术时间,降低术后并发症风险,且术后恢复较快,但在提高中远期生存率方面无明显优势。Objective To investigate the efficacy and safety of three surgical methods for resection of liver metastases of colorectal cancer.Method From January 2014 to January 2017,clinical data of 108 patients with liver metastases from colorectal cancer who underwent surgery were analyzed retrospectively.According to different surgical methods,patients were divided into 3D group(n=35)who underwent 3D laparoscopic-assisted hepatic metastasis resection,2D group(n=33)who underwent 2D laparoscopic-assisted hepatic metastasis resection,and laparotomy group(n=40)who underwent traditional open hepatic metastasis resection.Statistical analysis were performed by using SPSS 23.0 software.Surgical indicators were expressed as (■±s).The mean comparison between multiple groups was analyzed by single factor analysis of variance,and the pairwise comparison between multiple groups was tested by using LSD.Total incidence of complications and survival were expressed as rate and were examined by usingχ^2 test,A P value<0.05 was considered as statistically significant difference.Result In terms of operation time,intraoperative blood loss,anal exhaust time,and hospitalization time,comparison between three groups were as following:laparotomy group>2D group>3D group,with significant difference(P<0.05).There was no significant difference in the survival rate between the three groups 1 year,2 years,and 3 years after surgery(P>0.05).The total incidence of complications in the 3D group(11.4%)was not significantly different from 9.1%in the 2D group(P>0.05);the incidence of complications in the laparotomy group(30.0%)was higher than those in the 3D group and 2D group respectively(P<0.05).Conclusion The use of 3D laparoscopy for resection of liver metastases of colorectal cancer could reduce the operation time,the complications with a faster postoperative recovery.However,it has no obvious advantage in improving the long-term survival.

关 键 词：结直肠肿瘤 腹腔镜 存活率分析 手术后并发症 疗效比较研究 肝转移 

分 类 号：R73[医药卫生—肿瘤]