腹腔镜结肠癌根治术的临床评价

Clinical evaluation of laparoscopic radical resection of colon cancer

目的：探讨腹腔镜结肠癌根治术治疗结肠癌的临床疗效和安全性。方法：68例Ⅱ～Ⅲ期结肠癌患者按手术方式分为腹腔镜结肠癌根治术组（腹腔镜组）和常规开腹手术切除组（开腹组）。两种手术方法均遵循肿瘤根治的原则，术后给予统一的化疗方案。对两组肿瘤根治性、手术安全性、术后胃肠功能恢复、住院时间进行比较，随访3年观察肿瘤复发和3年无瘤生存情况。结果：腹腔镜组术后并发症发生率、手术切口大小、术中出血量均低于开腹组，相比较差异有统计学意义，P〈0．05；两组均无阳性切缘，淋巴结清除数、手术时间比较差异无统计学意义，P〉0．05；腹腔镜组术后通气时间、下床时间和住院时间与开腹组比较缩短，差异有统计学意义，P〈0．05；两组患者均获随访8～36个月，两组平均随访时间、局部复发率、远处转移率和3年无瘤生存率比较，差异均无统计学意义，P〉0．05。结论：腹腔镜结肠癌根治术是一种安全、有效、可行的微创手术方式，值得临床推广应用。

OBJECTIVE： To investigate the clinical efficacy and safety of laparoscopic radical resection for patients with colon cancer. METHODS：Totally 68 cases of patients with colon cancer were divided into laparoscopic radical resection （laparoscope group） and conventional open radical resection （laparotomy group）. The two surgical procedures must strictly comply with the principles of radical tumor and be given the same postoperative chemotherapy. After treatment the two groups effect of radical tumor, surgical safety, recovery time of gastrointestinal function and time of hospital stay were compared. Follow-up for 3 years, the recurrence rate of tumor and free survival rate of 3 years were observed. RESULTS： The incidence rate of postoperative complication, surgical incision and blood loss of laparoscope group were significantly lower than laparotomy group, the difference between two groups was significant （P 〈0.05）. There were no positive surgical margins, the number of lymph node dissection and surgical time were no significant difference between the two groups （P〉0.05）. The recovery time of gastrointestinal function and time of hospital stay of laparoscope group were significantly shorter, the difference between two groups was significant （P〈0.05）. Two groups of patients were followed up for 8 to 36 months. The average follow-up time, the local recurrence rate, distant metastasis rate and free survival rate of 3 years were no significant difference between the two groups （P〉0.05）. CONCLUSION： The laparoscopic radical resection for treating colon cancer is a safe, effective and feasible minimally invasive surgery, and worthy of clinical application.