结直肠癌患者腹腔镜下同时进行结直肠切除术和肝切除术的临床疗效

The clinical efficacy of colorectal resection and liver resection of colorectal cancer patients simultaneously under laparoscopic

目的探讨腹腔镜下同时进行结直肠切除术和肝切除术的临床疗效。方法收集2010年6月-2013年12月在该院住院治疗结直肠癌患者的临床资料进行回顾性分析。依据手术治疗方案和1∶1配对研究方法将患者分为腹腔镜组24例和开腹组24例。对两组患者的手术详细信息、肿瘤相关参数和术后疗效进行统计学分析。结果腹腔镜组手术平均时间为290 min,明显长于开腹组手术平均时间244 min(P=0.008)。腹腔镜组估计失血量为325 ml,多于开腹组估计失血量250 ml(差异无显著性,P=0.35)。但是腹腔镜组开始进食软食时间(3.0 vs 4.5,P<0.001)及术后住院时间(8.0 vs 10.5,P=0.001)明显缩短。腹腔镜组总体并发症率较低(17%vs 42%),但该差异无显著性(P=0.06)。腹腔镜组I、II级并发症(4%vs 33%,P=0.02)明显少于开腹组。结论腹腔镜下同时进行结直肠切除术和肝切除术安全可行,其术后恢复快、并发症少、住院时间短。

【Objective】To investigate the clinical efficacy of simultaneously conducting colorectal resection and liver resection of colorectal cancer patients under laparoscopic. 【Methods】Clinical data of hospitalized patients with colorectal cancer in June 2010 to December 2013 in our hospital were retrospectively analyzed. According to the surgical treatment and 1∶1 paired research method the patients were divided into laparoscopic group（24 cases）and laparotomy group（24 cases）. Operation details, tumor in patients with two groups of related parameters and postoperative curative effect were processed by statistical analysis.【Results】The average time of laparoscopy group was290 min, significantly longer than laparotomy surgery group with an average of 244 min（P =0.008）. Blood loss in laparoscopic group estimated was 325 ml, that was more than estimated blood loss of 250 m L compared with laparotomy group（there was no statistically significant difference, P =0.35）. But the eating pap time of the laparoscopic group（3.0 vs. 4.5, P〈0.001） and the time in hospital were（8.0 vs. 10.5, P =8.0） significantly shortened. The overall complication rate of laparoscopic group is lower（17% vs 42%）, but the difference is no statistical significance（P =0.06）. The complications in laparoscopic group I- class II（4% vs 33%, P =0.02） were significantly less than that in the laparotomy group. 【Conclusion】Conducting colorectal resection and hepatic resection at the same time in la-paroscopic is safe and feasible, the postoperative rapid recovery, fewer complications, with the shorter hospitalization time.