腹腔镜微创外科技术对结直肠癌肝转移患者的治疗效果观察

Effect of laparoscopic minimally invasive surgery on colorectal cancer patients with liver metastasis

目的:探讨腹腔镜结直肠癌联合肝转移灶切除术在治疗结直肠癌肝转移(CRLM)患者中的安全性、有效性。方法:选取2018年4月至2019年6月山西省肿瘤医院结直肠肛门外科收治的42例CRLM患者,男25例,女17例,年龄(57.38±2.72)岁,年龄范围为41~78岁,根据手术方式不同将其分为腹腔镜组(n=18)与传统开腹组(n=24),腹腔镜组患者行腹腔镜结直肠癌联合肝转移灶切除术,传统开腹组行传统开腹结直肠癌联合肝转移灶切除术。比较两组患者括手术时间、术中出血量、术后肛门排气或排便时间、术后住院时间、住院费用、术后并发症(术后吻合口瘘、膈下感染、肺部感染、切口感染)发生率等。结果:腹腔镜组患者手术时间[(193.24±15.68)min]长于传统开腹组[(170.63±16.39)min]、术中出血量[(52.82±11.04)ml]少于传统开腹组[(67.16±17.40)ml]、术后住院时间[(5.14±1.03)d]短于传统开腹组[(8.42±1.61)d]、手术费用[(6.58±1.04)万元]高于传统开腹组[(5.17±1.42)万元],差异均有统计学意义(P<0.05);腹腔镜组患者术后肛门排气或排便时间[(2.37±0.82)d]与传统开腹组[(2.64±0.79)d]比较,差异无统计学意义(P>0.05)。腹腔镜组患者术后并发症发生率[16.7%(3/18)]与传统开腹组[20.9%(5/24)]比较,差异无统计学意义(P>0.05)。结论:腹腔镜结直肠癌联合肝转移灶切除术不仅治疗效果显著,而且可有效降低并发症的发生率,具有较高的安全性、有效性。

Objective To investigate the safety and efficacy of laparoscopic resection of colorectal cancer combined with liver metastasis in patients with colorectal cancer liver metastasis(CRLM).Methods A retrospective study was performed on 42 cases of patients with CRLM who were admitted from April 2018 to June 2019.There were 25 males and 17 females,aged(57.38±2.72)years old,ranging from 41 to 78 years old.According to different surgical methods,they were divided into laparoscopic group(n=18)and traditional open group(n=24).Patients of the laparoscopic group underwent laparoscopic colorectal cancer combined with liver metastasis resection,while patients in the traditional open group underwent traditional open colorectal cancer combined with liver metastasis resection.The incidence of postoperative complications(postoperative anastomotic leakage,subphrenic infection,pulmonary infection,incision infection)was compared between the two groups.Results The operating time[(193.24±15.68)minutes]in the laparotomy group was longer than[(170.63±16.39)minutes]in the traditional open group,the intraoperative blood loss in the laparotomy group[(52.82±11.04)ml]was less than[(67.16±17.40)ml]in the traditional open group,the postoperative hospitalization time[(5.14±1.03)days]was shorter than[(8.42±1.61)days]in the traditional open group,the surgery cost[(6.58±1.04)ten thousand Yuan]was higher than[(5.17±1.42)ten thousand Yuan]in the traditional open group,and the differences were statistically significant(P<0.05),postoperative anal exhaust or defecation time of patients in the laparoscopic group[(2.37±0.82)days]was not significantly different from that in the traditional laparotomy group[(2.64±0.79)days],(P>0.05).The incidence of postoperative complications in the laparoscopic group[16.7%(3/18)]compared with the traditional laparotomy group[20.9%(5/24)],the difference was not statistically significant(P>0.05).Conclusion Laparoscopic resection of colorectal cancer combined with liver metastasis has not only significant therapeutic effect,but also can effectively reduce the incidence of complications,with high safety and effectiveness.