腹腔镜下结直肠癌肝转移一期手术23例临床疗效

目的探讨腹腔镜下治疗结直肠癌肝转移一期的安全性及有效性。方法回顾分析2011年1月至2013年6月行结直肠癌肝转移手术的43例患者的临床资料,将23例患者同时行腹腔镜切除肝转移灶切除术纳入腹腔镜组,20例患者同时行开放性肝转移灶切除术患者纳入开腹组。采用SPSS 23.0软件进行分析,中位生存时间、生存率及术后并发症比较采用χ2检验;计量资料采用(x珋±s)表示,比较采用独立样本t检验,生存分析采用Kaplain-Meire法计算生存率。P0.05表示差异有统计学意义。结果腹腔镜组患者手术时间及术后腹腔引流管留置时间较开腹组显著减少(P0.05);两组患者术中出血量、术后肛门排气时间及术后住院时间差异无统计学意义(P0.05);两组患者术后生存率相近,无围手术期死亡病例,术后均未见严重术后并发症。结论腹腔镜下结直肠癌肝转移一期联合切除安全可行,具有较好的疗效。

Clinical efficacy of one-stage laparoscopic resection in treatment of 23 patients with synchronous colorectal carcinoma liver metastasis

Objective To evaluate the security and feasibility analysis of resection for synchronous colorectal carcinoma liver metastasis at the same stage . Methods The clinical data of 43 cases of synchronous colorectal carcinoma liver metastasis patients in our hospital from January 2011 to June 2013 were retrospectively analyzed.23 patients who were performed laparoscopic hepatectomy and primary colorectal resection were assigned to the laparoscopic group , and another 20 patients who underwent open resection of liver metastases from colorectal cancer were defined as the operation group .All data were analyzed by SPSS 23.0.The median survival time, survival rate and postoperative complications were analyzed by χ2 test.The measurement data were designated by ( -x ±s) and were analyzed by t-test.Patient actuarial survival was determined by Kaplan-Meier analysis.There was significant difference if P <0.05. Results The operation time and indwelling time of drainage tube after operation in the laparoscopic group were significantly shorter than the operation group (P <0.05).T There were no significantly statistical differences in intraoperative blood loss , postoperative exhaust time and postoperative stay time between the two groups (P >0.05).The survival rate was similar between the two groups during three years follow -up. There were no perioperative death and seriously postoperative complications in the two groups . Conclusion First phase of the laparoscopic surgery for colorectal cancer primary tumors and liver metastatic carcinoma resection is safe and feasible, it has a good curative effect and positive prospect .