腹腔镜与开腹手术治疗结直肠癌的临床疗效及术后并发症的比较

Comparison of Clinical Efficacy and Complications of Laparoscopic Operation and Laparotomy in the Treatment of Colorectal Cancer

目的分析比较采用腹腔镜与开腹手术治疗结直肠癌的临床效果及术后并发症情况。方法回顾性分析进行手术治疗的120例结直肠癌患者的临床资料,其中60例腹腔镜手术患者作为治疗组,60例行传统的开腹手术患者作为对照组。对比分析2组患者的手术情况、术后恢复情况及并发症的发生情况。结果与开腹手术患者相比,腹腔镜患者的手术时间更长,手术切口长度明显更短,两者差异具有统计学意义(P<0.05)。腹腔镜患者术中出血量、输血患者、术后下床活动时间、术后住院时间、肠鸣音恢复时间、术后止痛药应用次数均少于开腹患者,差异均有统计学意义(P<0.05);2组患者在清扫淋巴结总数方面没有显著性差异(P>0.05)。腹腔镜组总的术后并发症发生率为10.00%,明显低于开腹组(36.67%)(P<0.05)。与开腹组相比,腹腔镜组术后的切口感染、肺部感染、肠梗阻发生率明显更低,2组差异具有统计学意义(P<0.05);而吻合口出血、下肢静脉血栓发生率在2组间的差异不明显,不具有统计学意义(P>0.05)。结论结直肠癌患者采用腹腔镜手术治疗创伤小、疗效佳,且并发症少,安全性高,值得广泛应用。

Objective To analyze the clinical efficacy and postoperative complications between laparoscopic surgery and open surgery for colorectal cancer. Methods Retrospective analysis of the clinical data of 120 cases of patients with colorectal cancer after surgery were conducted. 60 cases of patients treated with laparoscopic surgery were the treatment group,while 60 patients treated with traditional laparotomy were the control group. Comparative analysis of the 2 groups in surgical situation,postoperative recovery and complications were studied. Results Compared with open surgery patients,the surgery time was longer,and incision length was significantly smaller in patients with laparoscopic,the differences were statistically significant（ P〈0. 05）. The amount of intraoperative blood loss,patients with blood transfusion,postoperative bed activity time,hospital stay time,postoperative recovery time of bowel sound,painkillers application number of patients in laparoscopic group were less than laparotomy patients,the differences were statistically significant（ P〈0. 05）; the total number of cleaned lymph nodes of patients in the 2 groups had no significant difference（ P〉0. 05）. The total incidence of postoperative complications in laparoscopic group was 10. 00%,significantly lower than the open abdominal group（ 36. 67%）（ P〈0. 05）. Compared with the open surgery group,the rates of postoperative incision infection,anastomotic bleeding and intestinal obstruction in laparoscopic group were significantly lower,and the differences between the 2 groups had statistical significance（ P〈0. 05）,while there were no obvious difference in the incidence of pulmonary infection and lower limb venous thrombosis between the 2 groups（ P〉0. 05）. Conclusion For patients with colorectal cancer,laparoscopic surgery with the advantages of small trauma,good curative effect,fewer complications and high safety,is worthy of application.