腹腔镜与开放式多脏器切除结直肠癌的围手术期结果比较

Laparoscopic Versus Open Multivisceral Resection for Primary Colorectal Cancer:Comparison of Perioperative Outcomes

目的评估腹腔镜多脏器联合切除术治疗结直肠癌的安全性和可行性。方法对126例患者均进行了入侵或粘附周围器官或组织结构的结直肠癌联合切除术。比较了腹腔镜式和开放式切除术的围手术期效果。结果腹腔镜式和开放式多脏器联合切除术分别进行了60例和66例。6.7%的腹腔镜手术患者转换为开腹手术。腹腔镜手术组和开腹手术组相比,平均手术时间明显延长(分别为271 min和227 min),但是平均失血量明显减少(分别为40 ml和205 ml)。2组间的原发性肿瘤R0切除率(分别为95.0%和98.5%)、淋巴结切除数(均为18个)、术后并发症发生率(分别为28%和24%)不相上下。腹腔镜手术组和开腹手术组相比,平均住院时间明显减少(分别为13.5天和18天)。结论腹腔镜多脏器联合切除术对于治疗入侵或粘附周围器官的结直肠癌安全可行。

Objective To evaluate the safety and feasibility of laparoscopic resection of multiple organ in the treatment of colorectal cancer.Methods 126 patients were carried out the invasion of colorectal cancer or primary adhesion surrounding or-gans or tissue structures resection.The effect of perioperative laparoscopic and open resection were compared.Results Laparo-scopic and open multiple organ resection respectively had 60 cases and 66 cases.6.7%of patients converted to open surgery.The mean operative time in laparoscopic surgery group was significantly longer than open surgery group （ 271 minutes vs 227 mi-nutes）,but the average blood loss was significantly reduced （40 ml vs 205 ml）.R0 resection rates of the primary tumor （respec-tively 95.0%and 98.5%）,the number of lymph nodes dissection（both 18）,the incidence of postoperative complications （re-spectively 28%and 24%） between the 2 groups had no significant difference.The average length of stay in laparoscopic surgery group was significantly shorter than open surgery group （13.5 days and 18 days,respectively） .Conclusion Laparoscopic resec-tion of multiple organ for invasion or sticking around colorectal cancer is safe and feasible.