腹腔镜下结肠癌根治术与开腹结肠癌根治术近远期疗效的对比分析

Short-and Long-Term Efficacy of Laparoscopic Radical Resection and Open Radical Resection for Colon Cancer:A Comparison Analysis

目的:探讨腹腔镜下结肠癌根治术与开腹结肠癌根治术治疗结肠癌的近远期疗效。方法:选取2016年1月至2017年6月本院接受腹腔镜下结肠癌根治术的136例结肠癌患者作为病例组,另选取本院接受开腹结肠癌根治术的68例结肠癌患者作为对照组,比较两组患者的近远期疗效观察指标。结果:病例组患者的术中出血量、切口长度明显低于对照组患者,经t检验,差异存在统计学意义(P <0. 05),手术时间明显高于对照组患者,经t检验,差异存在统计学意义(P <0. 05),但淋巴结清扫数目无明显差异,经t检验,差异无统计学意义(P> 0. 05)。病例组患者的术后首次排气时间、术后镇痛时间、尿管留置时间、术后卧床时间及术后住院时间均明显低于对照组患者,经t检验,差异存在统计学意义(P <0. 05)。病例组患者的并发症发生率(7. 35%)明显低于对照组患者(19. 12%),经χ2检验,差异存在统计学意义(P <0. 05)。病例组患者与对照组患者的中位随访时间差异无明显差异,经t检验,差异无统计学意义(P> 0. 05);病例组患者的癌细胞转移率、局部复发率及1年和3年生存率均与对照组患者差异无明显差异,经t检验,对比无统计学意义(P> 0. 05)。结论:与开腹结肠癌根治术相比,腹腔镜下结肠癌根治术的手术安全性、术后恢复情况、并发症发生率均明显优于开腹结肠癌根治术,且远期疗效也能获得同开腹结肠癌根治术一致的根治效果。

Objective:To investigate the short-and long-term efficacy of laparoscopic radical resection and open radical resection for colon cancer.Methods:A total of 136 patients undergoing laparoscopic radical resection for colon cancer in our hospital from January 2016 to June 2017 were selected as the case group,and 68 patients with colon cancer who underwent open radical resection were selected as control group.The short-and long-term therapeutic effects of the two groups were compared.Results:The amount of bleeding and the length of incision in the case group were significantly lower than those in the control group(t-test,P<0.05).The operation time was significantly higher than that in the control group(t-test,P<0.05).But there was no significant difference in the number of dissected lymph nodes(t-test,P<0.05).First postoperative anal exhaust time,postoperative analgesia time,indwelling time of urinary catheter,postoperative bed rest time and postoperative stay in the case group were significantly lower than those in the control group(t-test,P<0.05).The incidence of complications in the case group(7.35%)was significantly lower than that in the control group ( 19. 12% ) (chi-square test, P<0.05). There was no significant difference between the two groups in median follow-up time, metastasis rate, local recurrence rate, 1 -year and 3-year survival rate (t-test, P >0. 05). Conclusion: Laparoscopic radical operationis superior to open radical operation for colon cancer in safety of operation, recovery and incidence of complications,and the long-term curative effect of the former is the same as that of the latter.