腹腔镜手术治疗结直肠肿瘤的效果评价与预后分析

目的评价腹腔镜手术治疗结直肠癌的临床效果,并对患者预后进行分析。方法选取2003年1月至2010年12月接受结直肠肿瘤治疗的患者746例,所有患者根据患者病理情况、分期和手术方法不同分为腹腔镜组和传统手术组,比较分析两组治疗方法的效果和预后。结果腹腔镜组较传统手术组手术时间短,术中出血量少,感染率和并发症少。随访观察6个月至5年,腹腔镜组转移率为2.95%;传统手术组转移率为10.19%,传统手术组术后转移率高于腹腔镜组,两组术后转移率差异显著(P<0.05)。腹腔镜组与传统手术组随访观察满3年生存率比较,腹腔镜组3年生存率高于传统手术组(P<0.05);3年复发率比较,腹腔镜组3年复发率低于传统手术组(P<0.05)。两组不同Dukes’分期死亡情况也不同。结论腹腔镜手术治疗结直肠肿瘤安全可行,且其效果可与传统开腹手术同等,甚至优于传统手术效果,腹腔镜治疗能够降低术后肿瘤转移率和复发率,提高患者生存率。

Clinical study on evaluation and prognosis of laparoscopic operation in treatment of colorectal cancer

Objective To evaluate the clinical effect of laparoscopic operation in treatment of colorectal cancer and to analyze its prognosis. Methods The clinical data of 746 patients with colorectal cancer treated in this hospital during January 2003 to December 2010 were retro- spectively reviewed and analyzed. All patients were divided into two groups according to pathological condition, stages of tumor and procedures for operation. Results The time of operation in patients of laparoscopy group was shorter than that of patients in traditional abdominal operation group, the amount of intraoperative blood loss was lesser than that of abdominal operation group. Postoperative incision infection rate and incidence rate of postoperative complications were lesser than those of control group. After follow - up for 6 months to 5 years, the percentage of metastasis in patients of laparoscopy group was 2.95%, and the percentage of metastasis in abdominal operation group was 10.19%. The difference in percent- age of metastasis between these two groups was statistically significant （ P 〈 0.05 ）. The 3 - year survival rate and recurrence rate of patients in two groups were significantly different（ P 〈0.05 ）. The mortality rates in various stages by Dukes＇staging were different in patients of two groups. Conclusion Laparoscopic operation for colorectal cancer is a safe, efficient and feasible procedure. The clinical effect of laparoscopic operation is better than that of laparocolotomy. The laparoscopic operation can significantly raise the survival rate of patients with colorectal cancer and it may lower the rates of distant metastasis and recurrence, hence it is worthy to be recommended for clinical application.