结肠癌腹腔镜下切除与开腹切除的短期疗效对比

Short Term Therapeutic Effect of Laparoscopic Surgery Versus Open Surgery for Colon Cancer

目的比较结肠癌腹腔镜辅助下切除与开腹切除的短期疗效。方法对2004年1月～2009年12月笔者所在医院行腹腔镜辅助下结肠癌根治术30例及开腹结肠癌根治术45例患者的临床资料进行回顾性分析,比较两组患者手术及术后情况。结果腹腔镜组与开腹组手术时间分别为(150.45±22.10)min和(148.56±28.55)min;切口总长度分别为(6.55±0.54)cm和(18.56±2.35)cm;出血量分别为(33.52±23.08)mL和(40.35±25.12)mL;淋巴结清除数分别为(12.53±2.36)枚和(13.24±2.05)枚;术后镇痛时间分别为(49.00±2.30)min和(89.00±9.30)min;术后下床活动时间分别为(30.85±7.09)min和(72.25±9.73)min;术后平均住院天数(6.05±1.09)d和(10.06±2.16)d;术后肛门排气时间分别为(25.08±6.89)min和(66.28±13.57)min;两组患者病理切缘均为阴性,均无术后并发症及术后死亡病例。结论腹腔镜辅助下结肠癌根治术安全可行,具有患者创伤小、术后康复快的优点,根治效果可达到开腹手术的水平。

Objective To investigate the feasibility and short term therapeutic effect of laparoscopic for colon cancer.Methods The clinical data of 30 cases underwent laparoscopic hemicolectomy for colon cancer and 45 cases underwent open hemicolectomy for colon cancer from January 2004 to December 2009 was retrospectively analyzed.Results The mean operative time of laparoscopic group and open group wa（s150.45±22.10）min an（d148.56±28.55） min.The incision length of laparoscopic group was obviously shorter than that of open grou（p6.55±0.54）cm an（d18.56±2.35）cm,and the operative blood loss of laparoscopic group and open group wa（s33.52±23.08）mL an（d40.35±25.12）mL obviously,there was no significant difference between the number of cleared lymph node（s12.53±2.36）and（13.24±2.05）.The gastrointestinal function of laparoscopic group recoveredmore quickly than open grou（p25.08±6.89）min an（d66.28±13.57）min.The postoperative hospital day was shorter in laparoscopic group than open group（6.05±1.09）d and （10.06±2.16）d.And after all,there were no different in postoperative complications,postoperative death.Conclusion The laparoscopic hemicolectomy for colon cancer was safe and effective.It has advantages of less pain and trauma,earlier postoperative recovery,and similar radical effect as laparotomy.