四种手术方式治疗结直肠癌肝转移的安全性及近期预后分析

Safety and short-term prognosis of four surgical methods for liver metastases of colorectal cancer

目的探讨四种手术方式治疗结直肠癌肝转移的安全性及近期预后分析。方法回顾性分析2016年5月至2018年11月收治的101例结直肠癌伴肝转移患者病例资料,根据术式不同分为4组,即A组(24例,同期腹腔镜手术)、B组(26例,同期开腹手术)、C组(22例,分期腹腔镜手术)和D组(29例,分期开腹手术)。采用SPSS 23.0统计分析软件,手术相关指标等计量资料以(±s)表示,两组间采用独立样本t检验,多组间采用单因素方差分析;术后并发症、生存率、复发率,比较采用χ^(2)检验;累积生存率比较应用Log-Rank检验。P<0.05为差异有统计学意义。结果四组手术时间、术中出血量比较,均为A组<C组<B组<D组,差异有统计学意义(P<0.05);术后总住院时间比较,A组<B组<C组<D组(P<0.05);四组并发症总发生率、术后2年的总生存率及复发率比较,差异均无统计学意义(P>0.05)。结论采用同期腹腔镜手术治疗结直肠癌肝转移患者,具有一定安全性和可行性,术后并发症风险并未因此增加,但在改善预后等方面无明显帮助。

Objective To evaluate the safety and short-term prognosis of four surgical methods for colorectal cancer with liver metastasis.Methods A retrospective analysis of the case data of 101 patients with colorectal cancer with liver metastases admitted from May 2016 to November 2018 was divided into 4 groups according to different surgical procedures,namely group A(24 cases,laparoscopic surgery at the same time)and group B(26 cases,simultaneous open surgery),group C(22 cases,staged laparoscopic surgery)and group D(29 cases,staged open surgery).SPSS 23.0 statistical analysis software was used.Surgery-related indicators are expressed as,independent sample t tests were used between the two groups,and one-way analysis of variance between multiple groups;postoperative complications,survival rates,and recurrence rates are compared byχ^(2) test;The cumulative survival rates were compared using log-rank test.P<0.05 was considered statistically significant.Results The operation time and intraoperative bleeding volume of the four groups were group A<group C<group B<group D,and the differences were statistically significant(P<0.05);the total hospital stay of group A<group B<group C<group D(P<0.05);There was no significant difference in the total complication rate,2-year survival rate and recurrence rate between the four groups(P>0.05).Conclusion Concurrent laparoscopic surgery for patients with liver metastases of colorectal cancer is safe and feasible,and the risk of postoperative complications does not increase,but has no significantly help in improving prognosis.