摘要
目的比较腹腔镜辅助与传统开腹右半结肠癌根治术在结肠癌治疗中的应用。方法将2000年1月至2003年1月需行右半结肠癌根治术的患者根据意愿分为接受腹腔镜手术和传统开腹手术2组,对比2组的手术安全性、术后恢复、肿瘤根治性、医疗费用和随访结果。结果腹腔镜组和开腹组分别有30、34例患者入组,两组均无术中术后严重并发症和手术死亡病例,腹腔镜组2例中转开腹手术;腹腔镜组手术时间、术中出血、术后并发症与开腹组差异无显著意义(P>005);腹腔镜手术患者排气时间、下床时间、住院天数分别为(224±056)、(394±164)、(1394±65)d,显著短于开腹组(P<005);腹腔镜组手术切除标本长度为(2271±461)cm,清扫结肠上旁淋巴结、系膜间淋巴结、血管根部淋巴结以及淋巴结总数分别为(682±472)、(259±243)、(182±253)与(1124±802)枚与开腹组无显著差异(P>005);手术费及药费合计与开腹组无显著差异(P>005);所有患者均获随访,腹腔镜组随访(8～36)个月,平均(2315±795)个月;开腹组随访(9～36)个月,平均(2219±746)个月。两组短期(≤3年)累计生存率差异无显著性意义(P>005)。结论腹腔镜辅助右半结肠癌根治术安全、有效、经济,符合肿瘤根治原则。
Objective To compare the results of laparoscopic and open right hemicolectomy in the management of colon carcinoma Methods We compared operation safety,recovery,complications,expenditure, oncological clearance and short term outcome for the two groups of patients undergoing either laparoscopic or open right hemicolectomy for colon cancer Results Between September 2000 and January 2003, 30 patients underwent a laparoscopic right hemicolectomy; 34 patients were treated via an open approach 2 patients in the laparoscopic group were converted to open surgery The mean operative time,blood loss, complications and expenditure were comparable in the two groups ( P >0 05); Flatus, time to resume early activity and hospital stay in laparoscopic group were 2 24±0 56、 3 94±1 64、 13 94±6 5 days respectively, which was significantly shorter than those in open group ( P <0 05) No significant difference between the two groups was observed for the oncological clearance, in terms of the number of lymph nodes removed and length of specimen ( P >0 05) The mean follow up time of the two groups were 23 15±7 95 and 22 19±7 46 months, respectively Local recurrence rate,metachronous metastases rate and cumulative survival probability at 36 months were similar for the two groups Conclusion These results suggest that laparoscopic right hemicolectomy for colon cancer can be performed safely, effectively and economically with the advantages of minimal invasiveness
出处
《中华普通外科杂志》
CSCD
北大核心
2004年第11期668-671,共4页
Chinese Journal of General Surgery
基金
上海市科技发展基金(024119106)
