腹腔镜与传统开腹手术治疗结直肠癌临床疗效比较

Efficacy comparison of laparoscopic surgery and traditional laparotomy in treatment of colorectal cancer

目的:探讨腹腔镜与传统开腹手术治疗结直肠癌的临床疗效。方法:选取某院收治的49例结直肠癌患者,根据患者意愿,分为腔镜组(25例)和传统开腹组(24例),对比分析2组患者手术时间、术中出血、淋巴结清扫数目、切除标本肿瘤下缘距下切缘的长度、术后胃肠道通气时间、术后住院时间、切口感染率、并发症发生率、远处转移率、复发率。结果:开腹组与腔镜组均无局部复发、远处转移及死亡的病例;2组患者的肿瘤下切缘、清扫的淋巴结数量、切口感染率、并发症发生率、局部复发率及远处转移率比较,差异均无统计学意义(P>0.05);腔镜组手术时间明显长于开腹组,术中出血腔镜组优于开腹组;在术后短期恢复方面腔镜组相对于开腹组的术后胃肠道通气时间,术后卧床时间,术后在院时间均有较明显的优势,差异有统计学意义(P<0.05)。结论:应用腹腔镜技术行结直肠癌根治术安全可行,完全可获得与传统开腹手术相似或更优的疗效,且具有创伤小、出血少、术后康复快等优点。

Objective：To compare the clinical efficacy of laparoscopy surgery and traditional laparotomy in treatment of colorectal cancer.Methods：49 patients with colorectal cancer treated in a hospital were divided into two groups：a laparoscopic group（25 cases）and a laparotomy group（24 cases）.The two groups were compared and analyzed in terms of the operation time,the intra-operative bleeding,the lymph node dissection,the length of the resection of the lower edge of tumor,the postoperative intestinal exhausting time,the hospitalization,the rates of incision infection,complications,distant metastasis and recurrence.Results：There were no cases of local recurrence,distant metastasis and death in the laparoscopic group and the laparotomy group.In comparison of the number of lymph node dissection,the length of the resection of the lower edge of tumor,the incision infection rate,the complication rate,the local recurrence rate and the distant metastasis rate,the two groups showed no statistical difference（P〉0.05）.The operation time of the laparoscopic group was significantly longer than that of the laparotomy group,and the intra-operative hemorrhage of the laparoscopic group was superior to the laparotomy group.As for the short-term recovery,the laparoscopic group was advantageous over the laparotomy group in terms of the postoperative intestinal exhausting time,bed-staying time and hospitalization,the difference being statistically significant（P〈0.05）.Conclusion：Laparoscopic surgery is safe and feasible for the treatment of colorectal cancer,with similar efficacy with or better efficacy than the traditional laparotomy surgery.It has advantages such as small trauma,less bleeding,and fast rehabilitation.