腹腔镜与传统开腹结直肠癌根治术临床疗效比较

Efficacy comparison between laparoscopic and traditional open radical resection for colorectal cancer

目的 探讨腹腔镜与开腹手术在结直肠癌根治术中的临床疗效.方法 对2011年3月至2016年1月成功施行手术治疗的106例结直肠癌患者的临床资料进行回顾性分析,其中腹腔镜结直肠癌根治术（腹腔镜组）55例,传统开腹结直肠癌根治术（开腹组）51例,比较两种术式患者的临床疗效.结果 手术时间：开腹组明显短于腹腔镜组[（141.2±40.6）min比（192.0±32.5）min,t=7.136,P〈0.05];术中出血量：腹腔镜组明显少于开腹组[（81.2±16.5）ml比（168.0±36.2）ml,t=16.077,P〈0.05],与开腹组相比,腹腔镜组术后胃肠功能恢复及术后留院时间显著缩短（t=12.236、t=9.524,均P〈0.05）;手术切除肠管长度、 术中淋巴结获取数以及术后相关并发症方面两组差异均无统计学意义（均P〉0.05）.两组均未发生死亡病例和严重并发症.随访10~60个月,两组局部复发和远处转移差异无统计学意义（均P〉0.05）.结论 腹腔镜结直肠癌根治术与传统开腹手术相比,是一种创伤小、出血少、恢复快的有效方法,值得临床推广应用.

Objective To investigate the clinical efficacy of the laparoscopic radical resection and the conventional laparotomy for colorectal cancer. Methods The clinical data of 106 patients with colorectal cancer treated by surgery from March 2011 to January 2016 were retrospectively analyzed, including 55 patients receiving laparoscopic surgery （laparoscopic group） and 51 patients treated by traditional surgery （conventional laparotomy group）. The clinical effects of both groups were compared. Results The operation time in conventional laparotomy group was shorter than that in laparoscopic group [（141.2 ±40.6） min vs. （192.0±32.5） min, t=7.136, P〈0.05]. The blood loss of the laparoscopic operation group was lower than that of conventional laparotomy group [（81.2 ±16.5） ml vs. （168.0 ±36.2） ml, t= 16.077, P0.05）. There were no severe complications and death case in both groups. Patients were followed up for 10-60 months, and there were no significant differences on recurrence and metastasis between two groups （P〉 0.05）. Conclusion Compared with the conventional laparotomy, laparoscopic radical resection is an effective method for the treatment of colorectal cancer with small trauma, less bleeding and fast recovery, which is worthy of clinical application.