腹腔镜与开腹结直肠癌根治术在合并COPD患者中的对比研究

Laparoscopic versus open colorectal resection for patients with chronic obstructive pulmonary disease

目的探讨在合并慢性阻塞性肺疾病(COPD)的结直肠癌患者中行腹腔镜结直肠癌根治术的可行性。方法 2008年10月～2012年12月117例合并COPD的患者接受结直肠癌根治术,其中74例接受腹腔镜手术(腹腔镜组),43例接受开腹手术(开腹组)。回顾性分析两组患者的临床资料,比较术后肺部并发症发生率。结果腹腔镜组术后发生肺部感染5例,肺不张2例,未出现气胸、ARDS、切口裂开病例;开腹组术后发生肺部感染3例,肺不张1例,ARDS 1例,切口裂开2例,未出现气胸病例。两组均无围术期死亡,各并发症发生率均无统计学差异。结论通过充分细致地围术期处理,合并COPD的患者行腹腔镜结直肠癌根治术是可行的。

Objective To explore the feasibility of laparoscopic colorectal resection for patients with chronic obstructive pulmonary disease （COPD）. Methods From Oct 2008 to Dec 2012, 117 patients with COPD underwent colorectal resection at The Second Clinical Institute of the North Sichuan Medical College. 74 patients underwent laparoscopic colorectal resection （laparoscopy group） and 43 patients underwent open colorectal resection（open group）. The clinical outcomes were studied and postoperative pulmonary complications were compared retrospectively. Results Pneumonia occurred in 5 cases in laparoscopy group and 3 cases in open group; Atelectasis occurred in 2 cases in laparoscopy group and in 1 case in open group. There were no pneumothorax, adult respiratory distress syndrome（ARDS） and incision dehiscence in laparoscopy group. There were no pneumothorax, but ARDS and incision dehiscence occurred in 1 case and 2cases in open group. There were no significant difference and no perioperative death in two groups. Conclusion Laparoscopic colorectal resection is feasible for patients with COPD.