结直肠癌肝转移患者行全腹腔镜与腹腔镜辅助同期切除手术的疗效观察

目的探讨结直肠癌肝转移(CRLM)患者采用全腹腔镜与腹腔镜辅助同期切除术治疗的临床疗效比较。方法选取2010年2月至2015年4月间大连大学附属新华医院收治的68例CRLM同期切除患者,采用随机数表法分为辅助组和全镜组,每组34例。辅助组患者采用腹腔镜结直肠癌(CRC)根治术联合开腹CRLM切除术治疗,全镜组患者采用全腹腔镜切除术治疗,比较两组患者术中术后指标、术后并发症发生率及生存时间。结果两组患者手术时间和术中出血量比较,差异无统计学意义(P> 0.05)。两组患者术后排便时间和住院时间比较,差异无统计学意义(P>0.05)。辅助组患者并发症发生率为44.1%,全镜组为32.4%,差异无统计学意义(P> 0.05)。两组患者无病生存时间和总生存时间比较,差异无统计学意义(P> 0.05)。结论全腹腔镜与腹腔镜辅助同期切除术治疗CRLM患者的安全性及有效性结果接近,临床可根据患者病情合理选择手术方式。

Effectiveness of total laparoscopic and laparoscopic-assisted simultaneous resection in patients with liver metastases from colorectal cancer

Objective To compared the efficacy of total laparoscopic and laparoscopic-assisted simultaneous resection of colorectal cancer liver metastasis( CRLM). Methods A total of 68 patients undergoing simultaneous resection of CRLM who were diagnosed and treated were selected at Xinhua Hospital Affiliated to Dalian University from February 2010 to April 2015. According to different surgical methods,they were randomly categorized into an auxiliary group and a total laparoscopic group with 34 patients in each group. The auxiliary group underwent colorectal cancer( CRC) combined with laparotomy for CRLM.The total laparoscopic group underwent total laparoscopic for CRLM. The intraoperative and postoperative indices,the incidence of postoperative complications,and the survival time were compared between the two groups. Results There was no significant difference in the duration of operation and intraoperative blood loss between the two groups( P > 0. 05). In addition,there was no significant difference in time to postoperative defecation and length of hospital stay between the two groups( P > 0. 05). The incidence of postoperative complications was 44. 1% in the auxiliary group which was higher than 32. 4% of total laparoscopic group( P > 0. 05). The disease-free survival time and overall survival time was higher in the auxiliary group than in the total laparoscopic group( P > 0. 05). Conclusion The safety and effectiveness of total laparoscopic and laparoscopic-assisted simultaneous resection of CRC are comparable,and the surgical method can be reasonably selected according to patient condition.