SSILS与常规腹腔镜手术治疗乙状结肠或上段直肠癌的疗效对比

Comparison of effectiveness of suprapubic single incision laparoscopic surgery(SSILS) and conventional laparoscopic surgery in patients with sigmoid colon and upper rectal cancer

目的比较经耻骨联合上单孔腹腔镜手术(suprapubic single incision laparoscopic surgery,SSILS)与常规腹腔镜手术治疗乙状结肠或上段直肠癌的疗效。方法选取2011年5月至2014年2月本院收治的86例乙状结肠或上段直肠癌患者为例,随机分为观察组与对照组,每组各43例。观察组采取SSILS,对照组采取常规腹腔镜手术。比较两组手术时间、术中出血量、淋巴结检出数目、总切口长度、排气时间、住院时间、并发症总发生率、随访期间局部复发率、远处转移率、3年无进展生存率与3年总生存率。结果观察组总切口长度与住院时间分别为(4.82±1.10)cm、(8.43±2.28)d,均显著低于对照组(均P<0.05)。两组并发症总发生率分别为6.98%、11.63%,差异无统计学意义(P>0.05)。两组局部复发率、远处转移率、3年无进展生存率、3年总生存率的差异均无统计学意义(均P>0.05)。结论 SSILS治疗乙状结肠癌或上段直肠癌具有较高安全性与良好肿瘤学疗效,与常规腹腔镜根治术相当,前者总切口长度减小、住院时间缩短,令患者获益更多。

Objective To compare effectiveness of suprapubic single incision laparoscopic surgery（SSILS） and conventional laparoscopic surgery in patients with sigmoid colon and upper rectal cancer. Methods 88 patients with sigmoid colon and upper rectal cancer were recruited and randomly assigned to the treatment group and control group, with 43 cases in each group. The treatment group was treated with SSILS, and the control group with conventional laparoscopic surgery. The operation time, intraoperative blood loss,number of resected lymph node, total incision length, exhaust time, hospitalization time, overall incidence of complications, local recurrence rate and distant metastasis rate during follow-up, 3-year progression-free survival rate and 3-year overall survival rate were compared between two groups. Results The total incision length and hospitalization time were（4.82±1.10） cm and（8.43±2.28） d, respectively, in the treatment group, which were lower than those in the control group（P〈0.05）. The overall incidence of complications in the treatment group and control group were 6.98% and 11.63%, respectively（P〉0.05）. The local recurrence rate and distant metastasis rate during follow-up, 3-year progression-free survival rate and 3-year overall survival rate did not differ significant between the two groups（P〉0.05）. Conclusion Compared with conventional laparoscopic surgery, SSILS has comparable effectiveness and safety in the treatment of sigmoid colon and upper rectal cancer. Total incision length was decreased and hospitalization time was shortened in SSILS group.