腹腔镜结直肠癌根治术的临床疗效分析

Clinical analysis of laparoscopic radical resection of colorectal cancer

目的 评价腹腔镜结直肠癌根治术的临床疗效。方法 比较2003年1月～2006年1月，同一手术组30例行腹腔镜（腹腔镜组）和46例行传统（传统手术组）结直肠癌根治术病例的术中出血量、手术当日输血人数、手术时间、术后吗啡用量、术后住院天数和手术前后的血红蛋白，同时观察手术切除肿瘤的大小、长度、淋巴结清扫数目以及随诊肿瘤的复发转移情况。结果 腹腔镜组的术中出血量、手术当日输血人数、术后吗啡用量和术后住院天数分别为（156±98）ml、3例、（10．7±3．9）mg、（8．6±2．0）d，明显少于传统手术组（P〈0．01）。腹腔镜组和传统手术组淋巴结清扫数目分别为（11．5±4．5）枚和（11．9±6．2）枚，直肠肿瘤远端切缘长度分别为（3．4±1．5）cm和（3．0±1．0）cm，复发率分别为3．3％和5．0％，转移率分别为6，7％和10．0％，病死率分别为3．3％和7．5％。上述观察指标两组比较差异无统计学意义。结论腹腔镜结直肠癌根治术可以达到与传统结直肠癌根治术同样的根治效果，且创伤小，恢复快。

Objective To investigate the clinical effect of laparoscopic radical resection of colorectal cancer. Methods Thirty laparoscopic and 46 traditional operation cases from January 2003 to January 2006 were studied retrospectively. The haemorrhage, number of patients received transfusion, operation time, dosage of morphine, postoperative hospital stay, size of tumor, the length of samples excised, the number of lymph nodes excised, local recurrence and distant metastasis rate after operation were observed. Results In laparoscopic group, the haemorrhage, number of patients received transfusion, dosage of morphine, postoperative hospital stay were （ 156±98） ml, 3 cases, （ 10.7± 3.9） mg, and （8.6± 2.0） days respectively, these results were better than that of traditional operation group. In laparoscopic group and traditional operation group, the numbers of lymph nodes excised were 11.5± 4.5 and 11.9 ± 6.2, and distance between tumor and lower end of rectal cancer excised were （3.4±1.5 ） cm and （3.0±1.0） cm,local recurrence after operation were 3.3% and 5.0%, distant metastasis rate after operation were 6.7% and 10.0%, and mortality after operation were 3.3% and 7.5%, respectively. There were no significant difference between two groups. Conclusions Laparoscopic radical operation have the same radical effects with traditional radical operation in treating colorectal cancer, which recover quickly with minimal trauma.