腹腔镜与开腹结直肠癌根治术临床疗效的对比研究

The comparison of clinical effect between laparoscopic and open radical operation on colorectal carcinoma

目的:比较腹腔镜与开腹结直肠癌根治术的临床疗效。方法:2003年1月至2007年1月同一手术组完成腹腔镜结直肠癌根治术52例及开腹结直肠癌根治术54例,比较两组的出血量、输血例数、手术时间、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、淋巴结清扫数以及随诊肿瘤的复发转移情况。结果:腹腔镜组的出血量为(152±97)ml、输血6例、术后吗啡用量(12.7±4.1)mg,术后住院日为(7.6±2.0)d,明显少于开腹组(P<0.01);腹腔镜组与开腹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;局部复发率分别为3.8%和4%,远处转移率分别为3.8%和6%,死亡率分别为7.5%和10%;1年生存率分别为96.7%、95.6%,3年生存率分别为80%、82.1%,上述指标两组无统计学差异(P>0.05)。结论:腹腔镜结直肠癌根治术可以达到与开腹结直肠癌根治术相同的根治效果,且患者创伤小、康复快。

Objective：To compare the clinical effect between laparoscopic and open radical operation of colorectal cancer.Methods：Fifty-two cases with laparoscopic operation and 54 cases with open operation during the period of Jan.2003 to Jan.2007 were compared in terms of blood loss,number of patients received transfusion,operative time,morphine used,hospitalization after operation,size of tumor,the length of samples excised,the number of lymphnodes excised,local tumor recurrence and distant metastasisrate after operation.Results：In laparoscopic group,the blood loss was（152±97）ml,six cases received transfusion,morphine used was（12.7±4.1）mg,hospitalization after operation was（7.6±2.0）day.The results were significantly lower than that of the open operation group.while no diference between two groups was observed in size of tumor,the length of samples excised,the number of lymph nodes excised,the distance between tumor and lower end of rectal cancer excised,local recurrence and distant metastasis rate after operation.Conclusions：Laparoscopic radical operation can reach the same radical effects as open radical operation in treating coloectal carcinoma.And patients underwent laparoscopy got lass damage and recovered more quickly.