腹腔镜右半结肠癌切除术后中长期随访分析研究

Medium and long-term outcomes of laparoscopic right hemicolectomy for colon cancer

目的探讨影响腹腔镜右半结肠癌切除术后患者生存时间的因素。方法收集并回顾性分析2004年2月至2011年3月间北京大学第三医院普通外科经腹腔镜施行右半结肠癌切除术患者的病例资料和随访资料．运用Kaplan—Meier法计算生存率并进行单因素分析，利用Cox比例风险模型进行多因素分析。结果164例腹腔镜右半结肠癌切除术患者中，中转开腹12例（7-3％）。围手术期并发症发生率为18．9％（31／164）。中位随访时间为27（5～85）个月。全组5年总体生存率为81．5％。5年无瘤生存率为75．7％，5年肿瘤相关生存率为78．7％。单因素分析和多因素分析结果均显示．TNM分期及中转开腹对患者生存时间的影响有统计学意义（P〈0．05）。结论TNM分期及中转开腹是影响腹腔镜右半结肠癌切除术后患者生存时间的独立因素。

Objective To evaluate factors associated with postoperative survival after laparoscopic right hemicolectomy for colon cancer. Methods Clinical data of patients undergoing laparoscopic right hemicolectomy in the Department of General Surgery, the Peking University Third Hospital from February 2004 to March 2011 were obtained and analyzed. Kaplan-Meier method was used to calculate survival rate and univariate analysis was performed. Proportional-hazards regression model（Cox model） was used for multivariate analysis. Results A total of 164 cases were included in this study. The conversion rate was 7.3%（12//164） and the postoperative morbidity was 18.9%（31/164）. After a median follow-up period of 27 months （range from 5 to 85 months）, the 5-year overall survival rate was 81.5% and the 5-year disease free survival rate was 75.7% and 5-year cancer related survival rate was 78.7%. Both univariate and multivariate analysis showed that the TNM staging and conversion were independent prognostic factors （P〈O.05）. Conclusion The tumor stage and conversion are independent prognostic factors for patients undergoing the laparoscopic right hemicolectomy.