完全腹腔镜治疗结肠癌伴同时性肝转移的临床疗效

Clinical efficacy of totally laparoscopic resection of colon cancer and synchronous liver metastases

目的:探讨腹腔镜下行结肠癌根治术与肝转移灶切除术的安全性及疗效。方法:选择2009年3月―2011年4月收治的50例结肠癌同时性肝转移患者,其中25例患者行腹腔镜下结肠癌根治术及肝转移灶切除术(腹腔镜组),另25例在传统开腹手术(开腹组)。比较两组患者的术中情况、术后恢复情况以及术后1、2、3年生存率。结果:腹腔镜组的术中出血量、术后镇痛时间、排气时间、住院时间及并发症均明显少于开腹组(P<0.05),但两组的手术时间差异无统计学意义(P>0.05)。两组患者术后1、2、3年生存率差异无统计学意义(均P>0.05)。结论:完全腹腔镜治疗结肠癌伴同时性肝转移安全可行,与开腹手术疗效相同,同时具有创伤小、术后恢复快、并发症少等优点。

Objective： To investigate the safety and efficacy of laparoscopic approach in radical resection of colon cancer and simultaneous resection of liver metastases.Methods： Fift y patients with colon cancer and synchronous liver metastases admitt ed from March 2009 to April 2011 were selected, of whom 25 cases underwent laparoscopic radical resection of colon cancer and simultaneous resection of liver metastases （laparoscopic group） and another 25 cases were subjected to the traditional open surgery （laparotomy group）. The intraoperative conditions, postoperative recovery, and postoperative 1-, 2- and 3-year survival rate between the two groups were compared. Results： The intraoperative blood loss, duration of postoperative analgesia, time to first fl atus, length of hospital stay, and incidence of postoperative complications were significantly decreased in laparoscopic group compared with laparotomy group （all P＆lt;0.05）, but no statistical difference was seen in operative time between the two groups （P＆gt;0.05）. The postoperative 1-, 2- and 3-year survival rate in the two groups of patients had no statisticaldifference （all P＆gt;0.05）.Conclusion： Totally laparoscopic resection of colon cancer and synchronous liver metastases is safe and effective, and can achieve the same clinical efficacy as open surgery. Meanwhile, it has the advantages of minimal invasiveness, fast postoperative recovery, and reduced complications.