腹腔镜联合开腹同期切除结直肠癌伴肝转移的可行性分析

The feasibility analysis of simultaneous laparoscopy combined with open resection on colorectal cancer with liver metastasis

目的探讨腹腔镜联合开腹同期切除手术方式在治疗结直肠癌伴肝转移的临床价值。方法选取2009年1月至2012年12月我院34例术前确诊为结直肠癌伴肝转移患者,其中19例行腹腔镜联合开腹同期切除结直肠癌及肝转移病灶作为治疗组,15例行传统开腹同期切除为对照组,观察两组近期疗效,对手术时间、术中出血量、术后首次排气时间以及术后并发症进行对比分析。结果 19例治疗组患者手术时间为(97±2)min,术中出血量为(106±2)mL,术后首次排气的时间为(2.65±1.58)d,住院时间为(11.26±1.89)d,均优于对照组患者(P<0.05)。治疗组的并发症发生率为10.53%,明显低于对照组的33.33%(P<0.05)。结论同期腹腔镜联合开腹手术治疗结直肠癌及肝转移是安全有效的,且术后恢复快,住院时间短,并发症发生率低,较传统开腹手术更加安全可靠,能为部分结直肠癌晚期患者的治疗提供了较好的选择方案。

Objective To study the clinical value of simultaneous laparoscopy combined with open on colorectal cancer asioeiated with liver metastasis. Methods The data was selected from 34 cases of preoperative diagnosis of colorectal cancer patients asiociated with liver metastasis from January 2009 to December 2012 in our hospital. Among 34 cases, 19 cases receiving simultaneous laparoscopy combined with open resection served as the treatment group, the other 15 cases receiving traditional open resection served as the control group. The surgical time, blood loss, postoperative first passing flatus time and postoperative complications were recorded and analyzed in two groups. Results In the treatment group, surgical time （97±2 min）, blood loss （106±2 mL）, the first postoperative passing flatus time （2.65±1.58 d）, hospitalization time （11.26±.89 d） were better than that in the control group （P〈0.05）. Complication rate in the treatment group （10.53%） was significantly lower than that control group （P〈0.05）. Conclusion Simultaneous laparoscopy combined with open resection on colorectal liver metastases is safe and effective, and with rapid postoperative recovery, short hospital stay, low complication rate, and is more secure and reliable than triditional open surgery treatment. For some patients with late stage colorectal cancer, this surgicalprocedure provides a better option.