老年右半结肠癌行腹腔镜根治术与开腹术的疗效比较

Therapeutic effect comparison of laparoscopic radical resection with laparotomy in aged patients with right colon cancer

目的对比老年右半结肠癌腹腔镜根治术和开腹根治术的手术效果。方法行右半结肠癌根治性切除术的老年患者72例。开腹组36例采用传统开腹根治术,腹腔镜组36例采用腹腔镜根治术。对比两组患者的手术时间、术中出血量、淋巴结清扫数目、术后肛门首次排气时间、术后住院天数和术后并发症的情况。结果两组患者的手术时间、淋巴结清扫数量对比,差异无统计学意义(P>0.05);腹腔镜组的术中出血量为(48.03±34.87)mL,术后肛门首次排气时间为(42.45±6.58)h,术后住院天数为(10.32±1.13)d,均显著少于对照组(P<0.05);腹腔镜组术后并发症的发生率为16.67%,开腹组术后并发症的发生率为11.11%,两组对比差异无统计学意义(P>0.05)。结论腹腔镜根治术对老年右半结肠癌肿瘤的清除效果和开腹手术相当,但腹腔镜根治术的创伤小,安全性良好,术后康复快。

Objective To compare efficacy of laparoscopic radical resection with laparotomy in aged patients with right colon cancer. Methods Of 72 aged patients of right colon cancer, 36 were treated with laparoscopie radical resection, and the other 36 with laparotomy. Operation time, intraoperative blood loss, number of lymph node dissection, postoperative anal exhaust time, postoperative hospital stay, and postoperative complications of both groups were compared. Results There was no statistical difference in operation time or number of lymph node dissection between the two groups. Intraoperative blood loss was （48.03±34.87） ml, postoperative anal exhaust time was （42. 45 ± 6. 58） h, and postoperative hospitalization was （10.32 ± 1.13） d in laparoscopic group, significantly less than those of the control group （P 〈0.05） ; The incidence of postoperative complications was 16.67% in laparoscopic group and 11.11% in laparotomic group （P 〉 0.05 ）. Conclusion Laparoseopic radical resection has the same tumors removal effect as laparotomy, but with less trauma, more safety, and faster postoperative rehabilitation for aged patients with right colon cancer.