3D与2D腹腔镜结直肠癌根治术临床疗效比较

Clinical effect analysis between 3D and 2D laparoscopic radical resection of colorectal cancer

目的比较3D与2D腹腔镜在结直肠癌根治术中的临床效果。方法回顾性分析2015年6月至2016年10月首都医科大学附属北京安贞医院行腹腔镜结直肠癌根治术67例患者的临床资料,其中2015年6月至2016年2月采用2D腹腔镜行结直肠癌根治术患者32例,设为2D腹腔镜组;2016年3—10月采用3D腹腔镜行结直肠癌根治术患者35例,设为3D腹腔镜组。比较2组患者手术情况、术后恢复情况及随访情况。结果 2组患者均顺利完成腹腔镜结直肠癌根治术,无中转开腹患者,无围术期死亡者。3D腹腔镜组患者手术时间和术中出血量均短于/少于2D腹腔镜组[(125±23)min比(166±28)min、(93±28)ml比(132±29)ml],差异均有统计学意义(均P<0.01)。2组切除结直肠标本长度、肿瘤直径、清扫淋巴结数目、肿瘤距下切缘距离比较,差异均无统计学意义(均P>0.05)。2D腹腔镜组患者术后首次排气时间、术后并发症发生率、术后住院时间、住院费用与3D腹腔镜组比较,差异均无统计学意义(均P>0.05)。2D腹腔镜组和3D腹腔镜组患者随访期间肿瘤复发和远处转移发生率比较,差异均无统计学意义(均P>0.05)。结论与2D腹腔镜比较,3D腹腔镜结直肠癌根治术具有手术时间短、术中出血少等优点,且安全可行,根治效果相当。

Objective To analyze the clinical effects of 3D and 2D laparoscopic radical resection of colorectal cancer. Methods Totally 67 patients who had laparoscopic radical resection of colorectal cancer from June 2015 to October 2016 in Beijing Anzhen Hospital, Capital Medical University were reviewed; 32 patients had 2D laparoscopic operation（2D laparoscopy group） and 35 patients had 3D laparoscopic operation（3D laparoscopy group）. Surgical records, postoperative recovery and follow-up data were analyzed. Results All patients had successful laparoscopic operation with no perioperative death. Operation time and intraoperative blood loss in 3D laparoscopy group were significantly shorter/less than those in 2D laparoscopy group［（125±23）min vs （166±28）min, （93±28）ml vs （132±29）ml］（P＜0.05）. Length of colorectal excision specimen, diameter of tumor, number of lymph nodes removed during operation, length between tumor and incisal edge had no significant differences between groups（P＞0.05）. Postoperative first exhaust time, complication rate, hospital stay time and hospital charges had no significant differences between groups（P＞0.05）. Tumor recurrence rate and metastasis rate during follow-up had no significant differences between groups（P＞0.05）. Conclusion Compared with 2D laparoscopy, 3D laparoscopy assisted radical resection of colorectal cancer shows advantages of short operation time and few intraoperative bleeding.