腹腔镜结直肠癌手术的临床对比研究

目的：探讨腹腔镜结直肠癌根治术的可行性。方法：2006年4月至2009年10月施行腹腔镜结直肠癌手术21例,传统开腹手术25例,对比两组患者的临床资料,总结腹腔镜手术的技术特点。结果：腹腔镜组2例中转开腹,占9.5%。腹腔镜组出血少（90±25）ml vs.（150±40）ml,P〈0.05],肠道功能恢复快（2.4±1.0）d vs.（3.6±1.8）d,P〈0.05],住院时间短（13.5±4.2）d vs.（17.6±5.8）d,P〈0.05],住院总费用明显多于传统手术组,手术并发症少（2 vs.7,P〈0.05）,两组手术时间、手术切除的肿块大小和清扫淋巴结数量差异无统计学意义（P〉0.05）。随访期内两组局部复发率、转移率及术后死亡率差异无统计学意义（P〉0.05）。结论：腹腔镜结直肠癌根治术安全、有效,值得推广。

Clinical comparative study of laparoscopic and traditional colorectal carcinoma surgery

Objective:To explore the feasibility of laparoscopic colorectal cancer radical operation.Methods:Twenty-one patients who underwent laparoscopic colorectal carcinoma operation and 25 patients who underwent open operation from Apr.2004 to Oct.2009 were included.The clinical data of patients in two groups were compared,and technical features of laparoscopic operation were summarized.Results:Two patients(9.5%) were converted to open surgery in laparoscopic group.Intraoperative blood loss was less in laparoscopic group than that in traditional open surgery group (90±25)ml vs.(150±40)ml,P<0.05].Bowel function restoration time was significantly shorter in laparoscopic group than that in open group (2.4±1.0)d vs.(3.6±1.8)d,P<0.05].Hospital stay was shorter in laparoscopic group(13.5±4.2)d vs.(17.6±5.8)d,P<0.05].Hospitalization total costs were higher in laparoscopic group than that in open group.The operative complications were less in laparoscopic group(2 vs.7,P<0.05).But no significant differences were detected between two groups in mean operative time,removed tumor size and lymph node harvest(P>0.05).There were no significant differences between two groups in local recurrence,metastasis rate and mortality during follow-up(P>0.05).Conclusions:Laparoscopic colorectal cancer radical operation is safe,feasible and worthy of generalization.