腹腔镜下结肠癌切除术应用于高危结肠癌患者治疗的价值

Clinical value of laparoscopic colectomy in the treatment of colonic cancer in high-risk patients

目的探讨腹腔镜结肠切除术应用于高危结肠癌患者治疗的临床价值。方法 60例高危结肠癌患者按手术方法分为两组,LCR组30例行腹腔镜下结肠癌切除术,对照组30例行开放结肠切除术。观察两组手术情况、围手术期并发症、淋巴结清扫数量、复发率。结果 LCR组平均手术时间与OCR组比较差异均无统计学意义(P>0.05),LCR组术中出血量、住院时间、肛门排气时间、术后前3d引流量、引流管拔除时间明显少于OCR组(P<0.05)。LCR组围术期并发症发生率显著低于OCR组(13.3%vs 43.3%,P<0.01)。LCR组TNMⅡ期及Ⅲ期淋巴结清扫数目均明显多于OCR组(P<0.05),术后复发率3.3%显著低于OCR组20.0%,差异有统计学意义(P<0.05),3年内生存率100.0%与OCR组93.3%比较差异无统计学意义(P>0.05)。结论腹腔镜下结肠癌切除术治疗高危结肠癌安全有效,符合肿瘤根治原则。

Objective To explore the clinical effect of laparoscopic colectomy in the treatment of colonic cancer in high-risk patients. Methods 60 cases of patients with colonic cancer were divided into two groups.The LCR group（n=30） was managed laparoscopic coleetomy and the OCR group（n=30） were traditional open operation.The operation condition, preoperative complications,amount of lymph node scavenged, and the relapse rate of the 2 groups were contrasted. Results The operation period of LCR group with no difference compared to OCR group（P 〉 0.05）,And the hospital stays,period of passage of gas by anus,the drainage volume post 3 days of operation,the period of drainage tube extraction and the intraoperative bleeding volume of LCR group was significant less than that of OCR group （P 〈 0.05）.There was significant difference in complication and the amount of lymph nodes scavenged of patients between 2 groups（13.3% vs 43.3%,P 〈 0.01）.The amount of lymph nodes scavenged of patients in TNM Ⅱ and Ⅲ of LCR group was more than that of OCR control group.The relapse rate in LCR group （3.3.%） was lower than that in OCR group（20.0%）,and the survival rate in 3 years（100.0%） of LCR group with no difference compared to OCR group（93.3%）（P 〉 0.05）. Conclusion Laparoscopie colectomy can be successfully performed for high-risk colonic cancer,with all the advantages of minimally surgery.