腹腔镜和传统开腹结肠癌根治术对患者近期疗效影响的比较

Comparison of Short-term Curative Effects of Laparoscopic and Open Radical Operation for Colon Cancer

目的对比分析腹腔镜手术(LAP)和传统开腹手术(OP)对结肠癌根治术患者的近期疗效。方法选取2011年2月至2014年10月渭南市中心医院收治并进行结肠癌根治术的80例患者作为研究对象。按照随机数字表法分为LAP组和OP组,各40例,LAP组采用腹腔镜结肠癌根治术,OP组采用开腹结肠癌根治术。对比分析两组患者术中观察指标,术后观察指标及并发症等情况。结果 LAP组患者手术时间、住院费用和清扫淋巴结个数均高于OP组[(2.8±0.3)d比(2.4±0.3)d,(23 657±2869)元比(20 365±2789)元,(14.5±2.1)个比(12.1±2.5)个,P<0.05];LAP组患者术中出血量、术后进食时间、肛门排气时间、术后吗啡使用量、术后镇痛时间及术后住院时间均显著低于OP组[(159±17)m L比(213±18)m L,(4.4±1.5)d比(5.5±1.9)d,(3.1±0.6)d比(3.4±0.5)d,(11.3±2.1)mg比(17.6±4.1)mg,(17±3)h比(29±5)h,(7.8±1.8)d比(10.5±1.8)d],差异有统计学意义(P<0.01);LAP组患者并发症发生率显著低于OP组[20.0%(8/40)比72.5%(30/40),P<0.01]。结论腹腔镜结肠癌根治术虽然手术时间较长,住院费用较多,但术中出血少,清扫淋巴结个数较多,且恢复较快及并发症少,与传统开腹手术相比具有很好的临床优势。

Objective To analyze the short-term curative effects of laparoscopic （LAP） and traditional open operation（OP） radical surgery for colon cancer. Methods Total of 80 patients with colon cancer in Weinan Central. Hospital from Feb. 2010 to Oct. 2013 were chosen. They were divided into LAP group and OP group according to random number table method,40 cases each. LAP group adopted laparoscopic surgery for colon cancer and OP group adopted laparotomy. The intra-operative, post-operative indexes and complications of the two groups were compared. Results The surgical time, hospitalization expenses and number of dissected lymph nodes of LAP group were higher than the OP group [ （ 2. 8 ± 0. 3 ） h vs （ 2.4± 0. 3 ） d, （ 23 657 ± 2869） yuan vs （20 365 ± 2789 ） yuan, （ 14.5 ± 2. 1 ） vs （ 12. 1± 2.5 ）, P 〈 0.05 ] ; the intraoperative blood loss,postoperative eating time, anal exhaust time,postoperative morphine consumption,postoperative analgesia time and postoperative length of hospital stay of the LAP group were lower than the OP group [（159 ±17） mLvs （213 ±18） mL,（4.4 ±1.5） dvs（5.5 ±1.9） d,（3.1±0.6） dvs（3.4±0.5） d, （11.3 ±2.1） mgvs（17.6±4.1） mg,（17±3） hvs（29±5） h,（7.8 ±1.8） dvs（10.5±1.8） d,P〈 0.05] ;the incidence of complications in the LAP group was significantly lower than the OP group [20. 0% （8/40） vs 52.5 % （30/40）, P 〈 0.01 ]. Conclusion Although laparoscopic colon cancer radical surgery needs longer time,the cost of hospitalization is higher,it has the clinical advantages of less intraoperative bleeding, more dissected lymph node number ,faster recovery and less complications, compared with the traditional open operation.