腹腔镜和开腹结肠癌根治术远期疗效分析

目的：评价腹腔镜和开腹结肠癌根治术在远期疗效方面的差异。方法：回顾性分析2003年10月—2009年6月由同一手术组医师实施的183例结肠癌根治术患者的临床资料,根据手术方式的不同分为腹腔镜手术组（n=81）和开腹手术组（n=102）,对2组患者在不同分期下的术后远期并发症、局部复发、远处转移及5年存活率进行比较。结果：2组患者在性别、年龄、病理类型、肿瘤位置等方面差异无统计学意义（P〉0.05）。除术后粘连性肠梗阻发生率腹腔镜手术组少于开腹手术组外（Ⅰ/Ⅱ期,7.0%vs22.6%,P=0.036;Ⅲ期,7.9%vs24.5%,P=0.042）,2组患者在切口疝、种植率、局部复发及远处转移方面差异均无统计学意义（P〉0.05）。5年累积存活率比较,Ⅰ/Ⅱ期腹腔镜手术组为77.4%,开腹组为75.7%,差异无统计学意义（P=0.626）;Ⅲ期腹腔镜手术组为71.8%,开腹手术组为65.6%,差异也无统计学意义（P=0.517）。结论：腹腔镜结肠癌根治术远期疗效与开腹手术相似,但术后远期并发症少,值得推广。

Analysis on long-term outcomes of laparoscopic versus open surgery for colon cancer

Objective： To evaluate the long-term effect of laparoscopic and open radical resection for colon cancer. Methods： One hundred and eighty-three patients with colon cancer from October 2003 to June 2009 were divided into laparoscopic surgery （LS）gr oup （n=102）and open surgery（OS）group（n=81）. Long-term postoperative complications, local recurrence, distant metastasis and 5-year survival rate were compared between the groups by stage. Results： There was no statistical difference in sex, age, pathological type and tumor location between the groups（P0.05）. The incidence of postoperative adhesive intestinal obstruction in LS group was significantly lower than that in OS group（7.0% vs 22.6% , P=0.036 in stageⅠ/Ⅱ; 7.9% vs 24.5% , P=0.042 in stage Ⅲ）, while there was no significant difference in the incidences of incision hernia, incision seeding, local recurrence and distant metastasis for different stage between the groups（P0.05）. The 5-year survival rates were 77.4% in LS group and 75.7% in OS group for stage Ⅰ/Ⅱ （P=0.626）, and 71.8% in LS group and 65.6% in OS group for stage Ⅲ（P=0.517）, respectively. Conclusion： Long-term effect of laparoscopic resection is similar to that of open resection for colon cancer, but laparoscopic surgery has less long-term complications.