腹腔镜辅助与开腹结直肠癌根治术临床疗效对比分析

Laparoscopic assisted colorectal cancer surgery and open colectomy for colon cancer

目的:对比腹腔镜辅助与开腹结直肠癌根治术临床疗效。方法:纳入2011年5月~2013年5月期间我院纳入的120例结直肠癌患者,前瞻性非随机地将患者分为腹腔镜手术组68例和开腹组52例。并观察两组一般手术情况,并发症发生情况,以及术前1d、术后1d、3d的CRP、WBC水平,以及远期肿瘤复发、远处转移和生存情况。结果:腹腔镜组患者手术时间以及淋巴结清扫数目与开腹组差异不具有统计学意义,但是腹腔镜组术中出血量、切口长度、术后排气时间、住院时间等指标均优于开腹组,差异具有统计学意义。术后腹腔镜组胃瘫发生率和总的并发症发生率显著低于开腹组,差异具有统计学意义。腹腔镜组术后1d、3d的CRP、WBC水平均较开腹组低,差异具有统计学意义。腹腔镜组术后1年生存率、复发率指标优于于开腹组,差异具有统计学意义,腹腔镜组术后3年生存率、复发率和远处转移率等指标均优于开腹组,差异具有统计学意义。结论:本研究结果表明,腹腔镜手术用于根治结直肠癌相比开腹手术具有创伤小、切口小、出血少、并发症少,炎症控制更优以及患者术后恢复更快等特点,远期疗效也更优。

Objective Comparison of laparoscopic assisted and open radical colorectal cancer radical curative effect. Methods A total of 120 patients with colorectal cancer were enrolled in our hospital from May 2011 to May 2013. Patients were divided into laparoscopic surgery group(n=68) and open group(n=52) according to their prospective non-randomized patients(depending on the patient's intention). And observe the two groups of general surgery, and complications occurred. The levels of CRP and WBC, as well as the recurrence, distant metastasis and survival of 1 D, 1 d and 3 days after operation. Results There was no significant difference between the operation time and the number of lymph node dissection in laparoscopic group, but the intraoperative blood loss, incision length, postoperative exhaust time and hospitalization time were excellent In the open group, the difference was statistically significant. The incidence of gastric palsy and total complication were significantly lower in the laparoscopic group than in the open group, the difference was statistically significant. The levels of CRP and WBC in laparoscopic group were significantly lower than those in laparotomy group. The 1-year survival rate and recurrence rate of laparoscopic group were better than those of laparotomy group. The 3-year survival rate, recurrence rate and distant metastasis rate of laparoscopic group. The difference was statistically significant. Conclusion This study result shows that laparoscopic surgery is used to effect a radical cure colorectal cancer compared with open surgery with small trauma, small incision, less bleeding, fewer complications, and better control inflammation as well as the characteristics of patients with postoperative recovery faster, the long-term curative effect is better.