腹腔镜与开腹结直肠癌根治术的近远期疗效比较

目的探讨分析腹腔镜下结直肠癌根治的安全性和可行性,对比其与开腹手术的近远期疗效。方法回顾性分析我院2006年1月至2011年12月间结肠及中上段直肠癌根治术患者的临床资料,其中开腹手术120例,腹腔镜下手术76例。分析比较两组患者的临床病理资料、围手术期情况及近远期生存情况。结果两组患者年龄、性别比较无统计学差异。腹腔镜组平均手术时间大于开腹组,分别为(226.28±61.09)min和(193.50±53.79)min;术中失血量腹腔镜组小于开腹组,分别为(84.00±28.41)ml和(187.60±37.27)ml;术后住院时间腹腔镜组小于开腹组,分别为(7.55±2.04)d和(8.40±3.39)d。两组患者肠管近端及远端切缘长度、清扫淋巴结数目以及术后感染性和非感染性并发症发生率比较,差异无统计学意义。开腹组与腹腔镜组结直肠癌患者术后3、5年生存率分别为76.8%、65.7%和76.6%、71.2%(P>0.05);Duke’s A、B、C各期两组患者生存率比较无统计学差异。结论腹腔镜结直肠癌根治手术安全可行,具有出血少、术后恢复快等优点,肿瘤安全性、并发症发生率及术后近远期疗效不亚于开腹手术。

Comparison of clinical efficacy of laparoscopic and open radical resection for colorectal cancer

Objective To investigate the safety and feasibility of laparoscopic radical resection for colonic and upper / median rectal cancer , and compare the short and long-term clinical efficacy of laparoscopic and open operations. Methods Clinicopathological data of 196 colorectal cancer patients undergoing laparoscopic (n=120) and open (n=76) radical resection in our hospital from January 2006 to December 2011 were analyzed retrospectively. The perioperative clinicopathological characteristics , postoperative complications and survival time were compared between the two groups. Results There were no significant differences in age and gender between the two groups. The operating time in the laparoscopic group was (226.28±61.09)min, significantly longer than (193.50±53.79)min in the open group. The blood loss was (84.00±28.41)ml in the laparoscopic group , significantly less than (187.60± 37.27)ml in the open group. The postoperative hospital stay was (7.55±2.04)d in the laparoscopic group, significantly shorter than (8.40 ±3.39)d in the open group. There were no significant differences in proximal and distal incision margin,number of dissected lymph nodes,and postoperative complications between the two groups. The 3- and 5-year survival rates were 76.6% and 71.2% in the laparoscopic group, 76.8% and 65.7% in the open group (P>0.05). There were no significant differences in survivals of the patients with Duke’s A, B,C stages respectively between the two groups. Conclusions Laparoscopic radical resection for colorectal cancer is feasible and safe with less blood loss ,shorter hospital stay,rapid recovery.Furthermore,as for oncological safety,postoperative complications,and short and long-term efficacy, laparoscopical resection is not worse than open resection.