腹腔镜与开腹结肠癌根治术短期疗效对比研究

Short-term effects of laparoscopic radical colectomy versus open surgery radical colectomy for colon cancer patients

目的比较腹腔镜与开腹结肠癌根治术的短期治疗效果。方法回顾性分析结肠癌行根治性手术治疗患者96例,其中行腹腔镜下结肠癌根治术(腹腔镜组)58例,行开腹结肠癌根治术(开腹组)38例。比较2组患者的手术时间、术中出血量、淋巴结清扫数量、术后排气时间、卧床时间、术后住院时间、术后切口感染等。结果腹腔镜组手术时间明显长于开腹组[(124.5±31.6)min vs(96.3±21.7)min,P<0.01],术中出血量明显少于开腹组[(54.28±16.1)mL vs(154.33±42.41)mL,P<0.01],术后肛门排气时间明显短于开腹组[(48.31±12.42)h vs(68.12±15.74)h,P<0.01],术后住院时间明显短于开腹组[(9.15±2.37)d vs(12.63±3.28)d,P<0.01],术后卧床时间短于开腹组[(39.21±9.07)h vs(57.33±12.32)h,P<0.01];腹腔镜组与开腹组的术后并发症差异无统计学意义[10.34%(6/58)vs 13.16%(5/38),P>0.05],复发率差异无统计学意义[5.17%(3/58)vs 5.26%(2/38),P>0.05],淋巴结清扫数目差异无统计学意义[(21.1±4.2)枚vs(20.8±3.9)枚,P>0.05]。结论腹腔镜结肠癌根治术在淋巴结廓清扫方面可达到与开腹手术相当的根治切除效果,且手术安全有效,具有创伤小、术后恢复快、术后住院时间短等优点。

Objective To investigate the short-term effects of laparoscopic radical colectomy versus open radical colectomy for colon cancer patients.Methods Retrospective analysis was performed in 96 colon cancer patients who underwent radical operation treatment,among which 58 cases underwent laparoscopic colonic resection（n=58）,38 cases underwent open surgery for colon cancer（n=38）.Comparative analysis was made for two groups of patients in operation time,bleeding amount,lymph node dissection number,postoperative fasting time,postoperative bed time,postoperative hospital stay,postoperative incision infection.Results The operative time of laparoscopic group was significantly longer than that of open surgery group,（124.5±31.6）min vs（96.3±21.7）min（P〈0.01）;the bleeding amount in laparoscopic group was significantly less than that of open group,（54.28±16.1）mLvs（154.33±42.41）mL（P〈0.01）;the postoperative fasting time of the laparoscopic group was shorter than that of open surgery group,（48.31±12.42）h vs（68.12±15.74）h（P〈0.01）.The postoperative hospitalization time of laparoscopy group was shorter than that of open group,（9.15±2.37）d vs（12.63±3.28）d（P〈0.01）;the postoperative bed time of laparoscopic group was shorter than that of open group,（39.21±9.07）h vs（57.33±12.32）h（P〈0.01）.The postoperative complications of laparoscopic group versus open surgery group showed no significant difference,10.34%（6/58）vs 13.16%（5/38）（P〈0.05）.There were no significant difference in recurrence rate between laparoscopic group and open group,5.17%（3/58）vs 5.26%（2/38）（P〉0.05）.There were no significant difference in the number of resected lymph nodes between two groups,（21.1±4.2）vs（20.8±3.9）（P〉0.05）.Conclusion Laparoscopic radical resection for colon cancer patients can achieve the effects with the open surgery in lymph node clearance,and the operation is safe and effective,with minimally invasion,faster postoperative recovery,shorter postoperative hospital stay.