腹腔镜与开腹结直肠癌根治术临床疗效分析

Comparative Study of Laparoscopic and Open Surgery for Colorectal Cancer

目的比较腹腔镜结直肠癌根治术与开腹手术的临床疗效。方法 2009年1月至2013年12月在本院行结直肠癌根治性手术的422例患者,根据其手术方式分为腹腔镜手术组(腔镜组)229例和开腹手术组(开腹组)193例,比较两组的一般资料、手术时间、出血量、疼痛评分、淋巴结数目、术后并发症及术后复发率。结果术中出血量(84.64mL vs 244.39mL)、术后第1d疼痛评分(3.51vs 6.44)、切口并发症(1.74%vs 8.29%)、肺部感染发生率(2.62%vs 8.29%)腔镜组优于开腹组(P<0.05),腔镜组手术时间明显长于开腹组(3.57hvs 3.11h,P=0.021),两组淋巴结数目(16.53vs 15.67)、复发率(6.79%vs 8.05%)差异无统计学意义。结论腹腔镜结直肠癌根治术近期疗效优于开腹手术,远期疗效与开腹手术相当。

Objective To compare the short-term and long-term outcomes of laparoscopic surgery versus open surgery for colorectal cancer.Methods The clinicopathologic factors and follow-up data of 422 cases with colorectal cancer after curative resection from January 2009 to December 2013 were analyzed retrospectively.The clinicopathologic factors,operation time,blood loss,number of removed lymph nodes and recurrence were compared between laparoscopic surgery group and open surgery group.Results There was no difference in clinicopathologic factors between the two groups,blood loss（84.64 ml vs 244.39ml）,rate of incision complications（1.74% vs 8.29%）and rate of lung infection（12.03 dvs.15.69d）were better in laparoscopic surgery group than in the open surgery group,but the operation time（3.57 hvs 3.11 h,P =0.021）was reversed.There was no difference in number of removed lymph nodes（16.53 vs 15.67）and recurrence rate（6.79%vs 8.05%）between the two groups.Conclusion The short-term outcomes of laparoscopic surgery are better than these of open surgery for colorectal cancer,and long-term outcomes are comparable.