腹腔镜下结直肠癌根治术66例临床分析

Clinical analysis of laparoscopic assisted radical resection for colorectal cancer

目的:比较腹腔镜下结直肠癌根治术与传统开腹手术围手术期的疗效与安全性,评价腹腔镜下结直肠癌根治术的可行性、安全性和肿瘤根治性。方法:回顾性分析腹腔镜下结直肠癌根治术(腹腔镜组)66例临床资料,包括手术相关指标、术后恢复指标、肿瘤根治性指标、术后并发症等情况,并与同期传统开腹手术(开腹组)95例进行比较。结果:腹腔镜组与开腹组的手术时间分别为(185.2±30.12)min和(121.3±20.45)min,术中出血量分别为(123.6±57.8)ml和(197.8±87.6)ml,差异均有统计学意义(P<0.01)。术后肠道排气时间:腹腔镜组为(2.87±0.25)d,开腹组为(3.52±0.19)d,差异有统计学意义(P<0.01)。2组术后并发症发生率差异无统计学意义(P>0.05);2组术后住院时间分别为(10.70±0.53)d和(13.97±0.28)d,腹腔镜组较开腹组明显缩短(P<0.01)。腹腔镜组清扫淋巴结个数明显少于开腹组(P<0.01),2组标本切缘阳性率差异无统计学意义(P>0.05)。2组患者术后3年生存率差异无统计学意义(P>0.05)。结论:与开腹手术相比,腹腔镜下结直肠癌根治术具有微创、出血少、患者术后疼痛减轻、胃肠功能恢复快、下床早等优势,同时能减少术后并发症及缩短术后住院时间,但手术时间长于开腹组。

Objective：To compare the efficacy and safety between laparoscopic assisted radical resection and laparotomy for colorectal cancer for evaluating the feasibility,safety and oncological clearance of laparoscopic assisted radical resection. Methods：The clinical data（including operation index,postoperative recovery index,radical index and postoperative complication） of 66 patients treated with laparoscopic assisted radical resection and 95 patients treated with laparotomy were compared. Results： The operation time and intraoperative blood loss in laparoscopy and laparotomy group were（185. 2 ± 30. 12） min （121. 3 ± 20. 45） min,and（123. 6 ± 57. 8）ml （197. 8 ± 87. 6） ml,respectively,the differences of which were statistical significance（P〈0. 01）. The postoperative anal exhaust time in laparoscopy and laparotomy group were（2. 87 ± 0. 25） day and（3. 52 ± 0. 19） day,the difference of which was statistical significance（P〈0. 01）. The difference of the incidence of postoperative complication between two groups was not statistical significance（P〈0.05）. The postoperative hospitalization time of laparoscopy（10.70 ±0.53） days was significantly shorter than that of laparotomy group（13. 97 ± 0. 28） days（P〈0. 01）. The number of resecting lymph node in laparoscopy group were significantly less than that in laparotomy group（P〈0. 01）. The differences of the positive rate of incisal edge and 3-year survival rate between two groups were not statistical significance（P〉0. 05）. Conclusions：The laparoscopic assisted radical resection for colorectal cancer is minimally invasive,less blood loss,less pain,quick recovery of gastrointestinal function and early out-of-bed,which can decrease the postoperative complications and stay.