腹腔镜结直肠癌手术与传统根治术临床对比研究

Clinical comparative study of laparoscopic colorectal carcinoma surgery and traditional colorectal carcinoma surgery

目的探讨腹腔镜结直肠癌切除术的临床疗效。方法对2006年4月至2009年10月完成的21例腹腔镜结直肠癌病例(腹腔镜组)与同期有可比性的25例传统结直肠癌根治术病例(传统手术组)资料进行对比分析。结果腹腔镜组2例(9.5%)中转开腹。腹腔镜组的术中出血量、肠功能恢复时间、切口长度及住院时间均明显少于传统手术组(P<0.05)。腹腔镜组住院总费用明显大于传统手术组(P<0.05)。两组手术时间、手术切除的肿块大小和清扫淋巴结数目比较差异无统计学意义(P>0.05)。手术并发症发生率分别为11.1%和28%,差异有统计学意义(P<0.05)。随访时间4～30个月,两组局部复发率、转移率及术后病死率比较差异无统计学意义(P>0.05)。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,是一项安全,可行的技术。

Objective To evaluate the advantages and disadvantages of Iaparoscopic surgery in colorectal cancer. Methods Clinical records of 21 cases of laproscopic colorectal operation from April 2006 to October 2009 were reviewed and compared with those of 25 comparable cases treated by conventional open surgery in the same period. Results In laparoscopic group,2 cases （8.3%） were converted to open surgery. Intraoperative blood loss and bowel function restoration time were significantly lower in laparoscopic group than those in traditional open surgery group（P〈0.05）. Operation costs were higher in laparoscopic group than that in traditional open surgery group （P〈0.05）.But No significant differences were detected between two groups in mean operation time,tumor size and lymphnode harvest （P〈0.05）. The overall morbidity rate was 11.1% and 28% respectively with significant difference （P〈0.05）. There were no significant differences between two groups in local recurrence,distant metastasis rate and mortality after operation （P〈0.05）. Conclusion Laparoscopic surgery has the same effects as traditional radical operation in colorectal cancer patients,and it is a safe and feasible technique with less surgical trauma and quicker recovery.