腹腔镜结肠、直肠癌根治术与开腹手术的临床对比(320例分析)

【摘要】〓目的〓比较腹腔镜结肠、直肠癌根治术与开腹手术的临床疗效。方法〓回顾性分析我院2009年7月至2014年12月期间行腹腔镜结直肠癌根治术156例患者及同期行开腹结直肠癌根治术164例患者的临床资料,比较两组患者的淋巴结清扫数目、切口长度、手术所需时间、术中出血量、术后肛门排气时间、术后肠道功能恢复时间、术后并发症发生情况、住院时间及3年生存率。结果〓腔镜组与开腹组的淋巴结活检数目分别为分别为12.89±3.44枚和14.33±3.38枚,两组相比较,差异无统计学意义(P均>0.05)。腔镜组与开腹组的切口长度分别为5.10±1.60 cm和15.2±2.51 cm,手术时间分别为196.75±21.54 min和153.82±14.85 min,术中出血量分别为85.63±35.73 mL和182.02±65.73 mL,下床活动时间分别为4.0±1.41天和6.8±1.82 天,肛门排气时间分别为 2.63±1.33天和4.70±1.39天,住院时间分别为10.76±2.10天和16.42±1.95天,住院总费用分别为3.69±0.30万元和3.03±0.37万元,两组相比较,差异均有统计学意义(P均<0.05)。腔镜组和开腹组并发症的发生率分别为5.8%和12.1%,两组比较,差异无统计学意义(P>0.05)。结论〓腹腔镜下结肠、直肠癌根治术安全、有效,与传统开腹手术相比,存在创伤更小、术后恢复更快的优点,远期疗效与开腹手术相当。

Laparoscopic surgery versus open surgery for treatment of colorectal cancer: outcomes of a retrospective study of 320 cases

【Abstract】〓Objective〓To compare the clinical effects between laparoscopic versus open radical resection for colorectal cancer. Methods〓A retrospective clinical data of 320 cases during the period from 2009 July to 2014 December were analyzed. Among them, 156 patients underwent laparoscopic radical resection of colorectal cancer (laparoscopic group), 164 cases of patients with open radical resection of colorectal cancer (laparotomy group). The number of lymph node dissection, length of incision, operation time, intraoperative bleeding, postoperative anal exhaust time, postoperative intestinal function recovery time, complications, hospitalization stay were observed and compared between the two groups. Results〓The number of lymph node biopsy in laparoscopic group and laparotomy group respectively were 12.89±3.44 and 14.33±3.38, no significant difference were found between the two groups (both P>0.05). The length of incision in laparoscopic group and laparotomy group were 5.10±1.60 cm and 15.2±2.51 cm. The operation time was 196.75±21.54 min and 153.82±14.85 min. The amount of bleeding was 85.63±35.73 ml and 182.02±65.73 ml respectively. Out-of-bed activity time was 4.0±1.41 and 6.8±1.82 days. The time of anus exhaust were 2.63±1.33 and 4.70±1.39 days. The length of hospital stay were 10.76±2.10 and 16.42±1.95 days, and total cost of hospitalization were 3.69×104±3000 and 3.03×104±3700 yuan. Compared between two groups, the differences were statistically significant (all P<0.05). Incidence of complications was found no difference between the two groups (5.8% vs 12.1%,P>0.05). Conclusion〓In this study, compared with the traditional open operation, laparoscopic resection of colorectal cancer was safe and effective, with advantage of less trauma and faster recovery, the long-term therapeutic efficacy was comparable with open operation.