腹腔镜结直肠癌手术与开放性手术的疗效及安全性分析

目的 对比腹腔镜手术与开腹手术对结直肠癌患者的疗效及安全性.方法 选取了361例结直肠癌患者,按随机数字表法分为2组.观察组(180例)行腹腔镜切除,对照组(181例)行传统开腹手术治疗.观察并记录患者近远期疗效、围手术期血清白细胞介素-6(IL-6)和白细胞介素-6(IL-8)水平、及随访3年期间并发症发生情况,以评价腹腔镜手术与开腹手术对结直肠癌患者的疗效及安全性.结果 2组在下床时间、排气时间、进半流食时间、排便时间上相比,差异没有统计学意义(P>0.05);观察组患者住院时间明显短于对照组(P<0.05).随访3年期间,2组在局部复发率、远处转移率及2年、3年生存率上相比,差异没有统计学意义(P>0.05).术后1 d,3 d 2组患者血清IL-6和IL-8水平均明显升高,但观察组患者血清IL-6和IL-8水平明显低于对照组.随访3年期间,观察组并发症共计11例,对照组19例,差异没有统计学意义(P>0.05).结论 采用腹腔镜手术治疗结直肠癌,近远期疗效与开腹手术相当,能减轻手术创伤引起的炎症反应,术后并发症少,手术安全性较传统开腹手术高,值得临床推广使用.

Efficacy and Safety of Laparoscopic Surgery and Open Surgery in the Treatment of Colorectal Cancer

Objective To study the efficacy and safety of laparoscopic surgery and open surgery in the treatment of colo -rectal cancer .Methods 361 patients with colorectal cancer were divided into 2 groups according to odd-even number of hospital-ization.The efficacy and safety of laparoscopic surgery and open surgery in the treatment of colorectal cancer were evaluated by long-term and short-term efficacy,IL-6 and IL-8 level during perioperative period and complications during 3-year follow-up.Re-sults There were no statistical significance in recovery time ,exhaust time,semi liquid diet time,defecation time between the 2 groups(P>0.05).The hospitalization of the observation group was shorter than that of the control group (P<0.05).During 3 years follow-up,there were no statistical significance in recurrence rate ,metastasis rate,2-and 3-years survival rates between the 2 groups.1 d and 3 d after surgery,the IL-6 and IL-8 level of serum significantly increased (P<0.05).During 3-year follow-up, there were no statistical significance in complications between the 2 groups(P>0.05).Conclusion Laparoscopic surgery for colorectal cancer has similar short-term and long-term efficacy as the open surgery .It can lighten the inflammation caused by sur-gical trauma and reduce the complications .The safety of laparoscopic surgery is higher than that of the open surgery .It is worthy of clinical use .