腹腔镜手术对比开腹手术在结直肠癌根治术中的安全性及远期疗效评估

Safety and Long-term Efficacy of Laparoscopic Surgery and Open Surgery for Colorectal Cancer

目的探讨开腹手术与腹腔镜手术在结肠癌根治术中的安全性及远期疗效。方法选取结直肠癌患者92例,将采用腹腔镜治疗的42例患者纳入研究组,将采用开腹手术治疗的50例患者纳入对照组。观察2组患者的手术时间,术中出血量,淋巴结清扫数目,腹腔引流量,肛门恢复排气时间,住院时间等疗效指标;观察2组患者术中术后并发症的发生情况;随访3年,对比2组患者的生存情况。结果观察组患者术中出血量,肛门恢复排气时间和住院时间均显著小于对照组,差异有统计学意义,P<0.05;观察组患者手术时间,淋巴结清扫数目,腹腔引流量与对照组相比差异无统计学意义,P>0.05。2组患者并发症发生率差异无统计学意义,P>0.05。观察组患者术后1年、2年、3年生存率分别为100.00%,95.23%,88.09%;对照组患者术后1年、2年、3年生存率分别为96.00%,86.00%,74.00%。2组3年生存率差异有统计学意义,P<0.05。结论腹腔镜手术治疗结直肠癌可达到传统开腹手术相当的治疗效果,其远期生存率高于传统开腹手术。

Objective To investigate the safety and long-term efficacy of open surgery and laparoscopic resection for colorectal cancer.Methods 92 cases of colorectal cancer were selected,42 patients received laparoscopic treatment was the study group,and 50 patients received open surgery treatment was the control group.Operation time,bleeding volume,number of lymph node dissection,flow rate of the abdominal cavity,time of recovery of anus,length of hospital stay and postoperative complications of the 2 groups were observed.Followed up for 3 years,the survival of the 2 groups were compared.Results Intraoperative bleeding,recovery time of anus and length of hospital stay in the observation group were significantly less than those of the control group,there were significant differences between the 2 groups,P〈0.05.Operation time,number of lymph node dissection,abdominal drainage volume of the 2 groups had no statistically significant difference,P〉0.05.There was no significant difference in the incidence of complications between the 2 groups,P〉0.05.In the observation group,1-,2-,3-year survival rates were 100.00%and 95.23% and 88.09%; in the control group,1-,2-,3-year survival rates were 96.00%,86.0%,74%,there had statistically significant difference in the 3-year survival rate,P〈0.05.Conclusion Laparoscopic for colorectal cancer can achieve the similar efficacy as traditional open surgery,the long-term survival rate is higher than the traditional open surgery.