腹腔镜与开腹手术治疗结直肠癌的近期疗效观察

The short-term effectiveness of laparoscopy versus open surgery for colorectal cancer

目的:对比分析腹腔镜与开腹手术治疗结直肠癌的近期临床疗效。方法:回顾分析2012年1月至2013年1月收治的91例结直肠癌患者的临床资料,根据住院号将患者分为两组,45例行开腹手术(开腹组),46例行腹腔镜手术(腹腔镜组),对比两组患者切口长度、手术时间、术中出血量、术后住院时间、术后切口感染率、术后止痛药使用人次、排气时间及淋巴结清扫数量等。采用SPSS 19.0统计软件进行统计分析。结果:腹腔镜组切口长度、术中出血量、手术时间、术后住院时间及术后止痛药应用人次优于开腹组,差异有统计学意义(P<0.05)。淋巴结清扫数量、排气时间、切口感染率两组相比差异无统计学意义(P>0.05)。结论:相较传统开腹手术,腹腔镜结直肠癌手术是安全、可行的,可取得与开腹手术相当的淋巴结清扫范围,且具有患者创伤小、术后疼痛轻等优点,但其远期效果尚需进一步研究。

Objective：To analyze and compare the short-term effectiveness of laparoscopy and open surgery for colorectal cancer. Methods：From Jan. 2012 to Jan. 2013,91 patients of colorectal cancer in the Second Hospital of Lanzhou University were divided into 2 groups ： open group （ n = 45 ） and laparoscopic group （ n = 46） by hospital number. The related outcomes of two groups were compared, which included length of incision, surgery duration, intraoperative blood loss, PoStoperative hospital stay, rate of incisional infection,level of postoperative pain, exhaust time, number of harvested lymph nodes. The data were analyzed by SPSS 19.0 software. Results：The laparoscopy group had significant advantages over the open surgery group in length of incision,intraoperative blood loss, surgery duration, postoperative hospital stay and the level of postoperative pain （ P 〈 0.05 ）, but no difference was found in number of harvested lymph nodes, exhaust time and rate of incisional infection （ P 〉 0.05 ）. Conclusions ： Laparoscopic eolorectal surgery is a safe, feasible, effective and minimally invasive technique with little postoperative pain in short term. Compared with the open surgery, the laparoscopy is the same effective in numbers of harvested lymph nodes. The long term effect of laparoscopy still needs further confirmation.