HALS与传统开腹手术在消化道肿瘤治疗中的临床对照研究

Clinical comparison between hand-assisted laparoscopy and open resection in the treatment of GI cancer

目的探讨手助腹腔镜(HALS,hand-assisted laparoscopic surgery)与传统开腹手术相比在消化道肿瘤治疗中的微创性及可行性。方法将31例消化道肿瘤根治患者分为两组,16例行手助腹腔镜肿瘤根治术,15例行传统开腹肿瘤根治术,比较两组的手术时间、术中出血量、切口长度、术后肛门排气时间、术后住院时间、费用、术后并发症。结果手助腹腔镜组与传统开腹组的平均手术时间(214.3min vs.205.8min)和切缘距肿瘤边缘(4.22cm vs.4.13cm)差异无统计学意义(P>0 05)。手助腹腔镜组术中平均出血量明显少于开腹组(56ml vs.106.5ml,P<0.05),切口长度差异有统计学意义(4.85cm vs.22cm,P<0.01)。手助腹腔镜组术后胃肠功能恢复时间明显早于开腹组(术后肛门排气时间2.54d vs.3.27d,P<0.05)。手助腹腔镜组住院时间明显短于开腹组(10.35d vs.12.8d,P<0.05)。手助腹腔镜组与开腹组均无严重并发症发生。结论手助腹腔镜消化道肿瘤根治术安全可行,并且具有创伤小、术后康复快等特点,是值得选择的微创手术方式。

Objective To study the feasibility and invasion of hand-assisted laparoscopic（HALHS）.Methods31 patients hospitalized during Dec.2008 to Jun.2009 with GI cancer were divided into HALS group and open operation group randomly.The.Data of two groups were compared.The index included operation time,blood loss,length of incision,postoperative venting time,hospital stay,complications.ResultsThe average operation time of HALS group was 214.3min,and control group was 205.8min（P〈0.05）.The intra-operative blood loss in HALH group was less than control group（56ml vs.106.5ml,P〈0.05）.Length of incision of HALS group was shorter than control group（4.85cm vs.22cm,P〈0.01）.The GI function of HALS group recovered faster than control group（postoperative venting time was 2.54d vs.3.27d,P〈0.05）.The hospitalization was shorter10.35d vs.12.8d,P〈0.05）.ConclusionHand-assisted laparoscope resection is feasible and safe for selected patients.The advantages were little trauma and quick recovery.