腹腔镜与传统结直肠癌根治手术疗效的临床对比

Clinical Comparison of Laparoscopic Surgery with Traditional Radical Surgery in Colorectal Cancer

[目的]比较腹腔镜和传统结直肠癌根治术的临床治疗效果。[方法]比较2003年1月至2006年1月,30例腹腔镜和46例传统结直肠癌根治术病例的术中出血量、输血人数、手术时间、术后吗啡用量、术后住院日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]腹腔镜组的出血量、输血人数、术后吗啡用量和术后住院日分别为(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分别为(11.5±4.5)枚和(11.9±6.2)枚,直肠肿瘤远端切缘分别为(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6.6%和10.0%,死亡率分别为3.3%和7.5%。上述观察指标两组差异无显著性。[结论]腹腔镜结直肠癌根治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。

[Purpose] To compare the effect of laparoscopic surgery with and traditional radical surgery in colorectal cancer, [Methods] Intraoperative blood loss, mumber of patients receiving blood transfusion, operative time, post-operative analgesic consumption, days of hospitalization after operation, and preand post-operative hemoglobin were compared between 30 cases with laparoscopie resection and 46 cases with traditional radical surgery in eoloreetal cancer patients from Jan. 2003 to Jan, 2006. The size of tumor, the length of samples excised, the number of lymph nodes dissected, local recurrence and distant metastasis after operation were also studied. [Results] In laparoscopic group, the blood boss, number of patients receiving blood transfusion, post-operative analgesic consumption, days of hospitalization after operation were （156±98）ml; 3 cases; （10.7±3.9）mg; and （8.6±2.0） days respectively, which were significantly lower than those in traditional operation group. In laparoscopic group and traditional operation group, the number of lymph nodes dissected was 11.5±4.5 and 11.9±6.2; length of tumor to margin was （3.4±1.5）cm and （3.0±1.0）cm, local ,ecu,rence was 3.3% and 5.0%, distant metastasis rate was 6.6% and 10.0%, and mortality after operation was 3.3% and 7.5%, respectively with no significant difference. [Conclusion] Laparoscopic surgery have the same effect with traditional radical operation in colorectal cancer patients, with less surgical trauma and quick recovery.