腹腔镜结肠癌根治术的临床疗效评估

Clinical evaluation of laparoscopic radical resection of colon cancer

目的评价腹腔镜结肠癌根治术的临床疗效。方法对2000年1月到2004年1月间于浙江大学医学院附属邵逸夫医院进行腹腔镜与传统开腹结肠癌根治术病例共102例,作同期非随机对照研究。其中,腹腔镜结肠癌根治术(腹腔镜组)47例,常规开腹结肠癌根治术(开腹组)55例。比较两组病例术中和术后情况、病理分期及随访结果。结果2组病例在年龄、性别和手术方式方面差异均无统计学意义。腹腔镜组平均手术时间长于开腹组[分别为(182±62)min和(141±37)min],而其术后住院时间明显缩短[分别为(5.3±1.9)d和(8.2±1.2)d]。两组切缘均为阴性,淋巴结清扫数和Dukes分期差异无统计学意义。随访12～48个月(平均21个月),两组均未发现切口转移,两组局部复发和远处转移差异也无统计学意义。结论腹腔镜结肠癌根治术具有切口小、创伤轻、恢复快的优点;而在根治彻底性、复发率与生存率方面与传统开腹手术无明显差异。

Objective To investigate the clinical effect of laparoscopic radical resection of colon cancer. Methods Patients with colon cancer who underwent radical resection during January 2000 to January 2004 in Sir Run Run Shaw Hospital （ Medical College of Zhejiang University） were divided into open and laparoscopic groups for a non-randomized case-control study. All the patients were followed up and their clinical and pathological results were compared. Results No difference was seen between the two groups on the patients＇ age, gender, lymph node numbers and Dukes staging. The laparoscoplc group had a longer mean operation time [ （ 182 ±62） rain vs （ 141 ±37）mini and shorter hospital stay [ （5. 3 ± 1.9）d vs （8.2 ± 1.2）d] than the open group. All surgical margins were pathological negative. Post-operation follow up was 12-18 months （mean 21 months）. No incision recurrence was found in neither group. As far the local recurrence and distal metastasis rate were similar in both groups. Conclusions Laparoscopic radical resection of colon cancer has minimal invasion and shorter recuperation than open procedure, the radicalness and either local recurrence or distal metastasis rate after surgery are similar when compared with open group.