腹腔镜下结肠癌根治术的安全性及有效性研究

Research on Safety and Effectiveness of Laparoscopic Radical Colectomy for Colon Cancer

目的探讨腹腔镜下结肠癌根治术的安全性及有效性。方法回顾性分析2011年1月至2012年1月期间传统开腹结肠癌根治术患者(对照组,56例)与2013年1月至2014年1月期间腹腔镜下结肠癌根治术患者(观察组,56例),比较两组患者临床指标、并发症发生率、术后肿瘤局部种植率与肿瘤转移率之间的差异。结果观察组患者手术时间、肠道排气时间、术后进食时间、术后镇痛时间、住院时间明显短于对照组,术中出血量明显少于对照组,平均活检淋巴结明显高于对照组,两组比较差异具有统计学意义(P<0.05)。观察组术后并发症发生率明显低于对照组,两组比较差异具有显著性(P<0.05),全部患者均未发生术后大出血、吻合口瘘、大便失禁、排尿障碍等严重并发症与死亡。两组患者术后肿瘤局部种植率与肿瘤转移率比较差异无统计学意义(P>0.05)。结论腹腔镜下结肠癌根治术有助于显著缩短病程,明显降低并发症发生风险,促进疾病的早期恢复,且不增加肿瘤局部种植与转移风险,具有良好的安全性与有效性。

Objective To study the safety and effectiveness of laparoscopic radical colectomy for colon cancer. Method A retrospective analysis was conducted on the difference of clinical indexes, complication rates, and tumor metastasis rate between traditional open colectomy patients（control group, 56 cases） from January 2011 to January 2012 and radical laparoscopic colectomy patients from January 2013 to January 2014（observation group, 56 cases）. Results The length of surgery and hospitalization, time interval between surgery and intestinal exhaust, first postoperative feeding, analgesia of the observation group were significantly shorter than that of the control group. Intraoperative blood loss was significantly less in the observation group, and the average number of biopsy lymph nodes was significantly larger than in the observation group（P〈0.05）. Incidence rate of postoperative complications was statistically lower in the observation group（P〈0.05）, and there were no serious complications including postoperative hemorrhea, anastomotic fistula, fecal incontinence, urination dysfunction and death in the observation group. The postoperative local tumor implantation rate and tumor metastasis rate was not statistically different between the two groups（P〉0.05）. Conclusion Laparoscopic radical colectomy for colon cancer helped to shorten disease course and reduce the risk of complications significantly, and to promote early recovery of the diseases without increasing the risk of postoperative local tumor implantation and tumor metastasis. It was proved to have good safety and effectiveness in the study.