结直肠癌根治术腹腔镜手术与开腹手术的短期疗效对比

Comparison of Short-term Effect between Laparoscopic and Open Radical Resection for Colorectal Cancer

目的:对比结直肠癌根治术腹腔镜辅助与开腹手术的短期疗效。方法:对2011年1月1日-10月31日笔者所在科行结直肠癌腹腔镜手术患者67例、开腹手术60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:腹腔镜组手术时间大于开腹组,分别为(238.54±4.88)min、(182.95±6.53)min,;腹腔镜组出血量小于开腹组,分别为(136.08±13.70)ml、(189.53±14.80)ml;切口总长度腔镜组明显小于开腹组,分别为(4.92±0.14)cm、(23.14±0.32)cm;淋巴结清除数分别为(9.85±0.43)枚、(10.63±0.89)枚;术后通气天数分别为(3.51±0.17)d、(4.16±0.29)d;术后平均住院时间(11.68±0.42)d、(13.56±0.91)d;术后腹腔镜组出现1例输尿管损伤,1例吻合口漏,开腹组出现2例输尿管损伤。两组均无术后死亡病例,两组患者术后病理示肿块切缘为阴性。结论:腹腔镜辅助下结肠癌根治术安全可行,腹腔镜结直肠手术解剖层次清晰,近期效果明显,具有微创、术后恢复快等优点,且根治效果与开腹手术效果相似。

Objective ：To investigate the shortterm effect of laparoscopic and open radical resection for colorectal cancer. Methods ：The clinical data of 67 cases underwent laparoscopic radical resection for colorectal cancer from January 2011 to October 2011 and 60 cases underwent open radical resection for colorectal cancer were collected and retrospectively analyzed. Results ：The mean operative time of laparoscopic group was longer than open group, they were （238.54 ± 4.88）min and （182.95 ± 6.53）min （P〈0.001）.The blood loss during operation of laparoscopic group was less than open group, they were （136.08±13.70）ml and （189.53± 14.80）ml （P〈0.001）.The incision length of laparoseopic group was obviously shorter than open group, they were （4.92 ±0.14）cm and （23.14 ± 0.32）cm （P〈0.001）. There was no significant difference of the number of cleared lymph nodes [（9.85 ± 0.43） and （10.63 ± 0.89）, P〉0.05] and the recovery of gastrointestinal function [（3.51 ±0.17）d and （4.16± 0.29）d, P〉0.05] between laparoseople group and open group.The postoperative hospital day of [aparoseopic group and open group were （11.68 ±0.42）d and（13.56 ±0.91）d. There was no statistical difference between two groups（P〈0.05）.Postoperative complications ： there was one case of ureteral injury and one ease of stomal leak of laparoscopie group, meanwhile, there were two cases of ureteral injury of open group.There was no postoperative death of these two group, and pathology of the incisal edge was negative. Conclusion ：The laparoscopic radical resection for colorectal cancer is safe and effective. And the anatomical layer of laparoscopic radical resection is very clear, compared to open radical resection, it has advantages of less pain and trauma, earlier postoperative recovery, and similar radical effect as laparotomy.