两种手术径路大肠癌根治术后的肿瘤学安全性结果分析

Clinical analysis of oncologic results using two different surgical ways for patients with rectal or colon cancer

目的比较腹腔镜和传统开腹大肠癌根治术在肿瘤学安全性方面的区别。方法回顾性分析江苏省金湖县人民医院2008年1月至2012年12月期间126例行大肠癌根治术的TNMⅠ~Ⅲ期病例的临床随访资料。其中腹腔镜组46例,开腹组80例,两组患者一般资料及辅助治疗情况无明显差异（P〉0.05）。比较两组患者术后复发、生存等肿瘤学指标。结果所有患者的临床资料均以随访36个月为准。腹腔镜组与开腹组比较：3年累积生存率为84.1%比82.9%,远处转移率为13.6%比17.1%,戳孔/切口癌转移率为0比0,差异均无统计学意义（P〉0.05）;局部复发率为6.8%比11.8%,其中Ⅲ期病例腹腔镜组局部复发率显著低于开腹组（P〈0.05）。结论腹腔镜大肠癌根治术安全、有效,远期疗效与开腹手术相当。

Objective To compare the oncologic results between laparoscopic and open approach for the treatment of rectal cancer or colon. Methods One hundred and twenty-six patients with rectal cancer or colon from Jan. 2008 to Dec. 2012 were randomly divided into laparoscopic and open surgery group. Local recurrence, distant metastasis and survival rate were compared between two groups. The recurrence, survival and other indi- cators of oncology of the two groups were compared. Results Fifty-six cases received laparoscopic resection and eighty cases received open operation. There were no statistically significant differences of demographic data be- tween two groups（P 〉 0. 05 ）. The clinical data of all patients are followed up for 36 months. No statistically significant differences were observed in 3-year cumulative survival rate （84. 1% in laparoscopic and 82. 9% in open approach ）, distant metastasis rate（ 13.6% in laparoscopic and 17. 1% in open approach ）,the differ- ences of local recurrences rate （6. 8% in laparoscopic and 11.8 % in open approach） , the TNM stage III laparo- scopic cases of local recurrence rate was significantly lower than that in open group（ P 〈 0. 05 ）. Conclusions Laparoscopic treating rectal or colon cancer was safe and effective. Comparison of laparoscopic and open surger- y, Long-term efficacy was fairly.