腹腔镜辅助根治术治疗异时性多原发结直肠癌的近期疗效分析  

Short-term efficacy of laparoscopic-assisted radical surgery for metachronous multiple primary colorectal cancer

作　　者：李吉云 田若曦 程璞 刘恒昌 陈海鹏 郑朝旭 Li Jiyun;Tian Ruoxi;Cheng Pu;Liu Hengchang;Chen Haipeng;Zheng Zhaoxu(Department of Colorectal Surgery,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Science and Peking Union Medical College,Beijing 100021,China)

机构地区：[1]国家癌症中心、国家肿瘤临床医学研究中心、中国医学科学院北京协和医学院肿瘤医院结直肠外科,北京100021

出　　处：《中华普通外科杂志》2025年第2期119-122,共4页Chinese Journal of General Surgery

基　　金：中国癌症基金会北京希望马拉松专项基金(LC2021A23)。

摘　　要：目的探讨腹腔镜辅助根治术在异时性多原发结直肠癌(metachronous multiple primary colorectal cancer,MCC)治疗中的安全性及有效性。方法回顾性分析2012年1月至2022年1月在中国医学科学院肿瘤医院结直肠外科接受腹腔镜辅助根治术的27例MCC患者(腹腔镜组)和接受开腹根治术的36例MCC患者(开腹组)的临床资料。结果腹腔镜组在术中出血量[(53.7±111.5)ml比(132.5±154.9)ml,t=-2.241,P=0.029]、术后首次排气时间[(2.2±0.7)d比(3.5±0.6)d,t=-7.752,P<0.001]、术后首次排便时间[(2.9±0.6)d比(4.3±0.6)d,t=-8.841,P<0.001]及术后住院时间[(7.2±2.4)d比(10.6±3.5)d,t=-4.518,P<0.001]方面均优于开腹组,差异均有统计学意义。两组手术时间、淋巴结清扫数目、标本切缘阳性率、首次肠癌手术吻合口切除率、术后并发症发生率相比差异均无统计学意义(均P>0.05)。结论腹腔镜手术对MCC患者是一种安全、创伤较小的开腹手术替代方案。Objective:To explore the safety and efficacy of laparoscopic-assisted radical surgery in the treatment of metachronous multiple primary colorectal cancer(MCC).Methods:A retrospective analysis was conducted on 27 MCC patients undergoing laparoscopic-assisted radical surgery(laparoscopic group)and 36 MCC patients undergoing open radical surgery(open group)from Jan 2012 to Jan 2022 at the Department of Colorectal Surgery,Cancer Hospital,Chinese Academy of Medical Sciences.Results:The laparoscopic group was superior to the open group in terms of intraoperative blood loss[(53.7±111.5)ml vs.(132.5±154.9)ml,t=-2.241,P=0.029],time to first postoperative flatus[(2.2±0.7)days vs.(3.5±0.6)days,t=-7.752,P<0.001],time to first postoperative defecation[(2.9±0.6)days vs.(4.3±0.6)days,t=-8.841,P<0.001],and postoperative hospital stay[(7.2±2.4)days vs.(10.6±3.5)days,t=-4.518,P<0.001].There were no significant differences between the two groups in terms of operation time,number of lymph nodes dissected,positive rate of specimen margin,resection rate of previous colorectal cancer anastomotic stoma,and incidence of postoperative complications(all P>0.05).Conclusion:Laparoscopic surgery is a safe and minimally invasive alternative to open surgery for MCC patients.

关 键 词：结直肠肿瘤 腹腔镜 

分 类 号：R735.34[医药卫生—肿瘤]