腹腔镜辅助与开腹手术治疗原发性小肠肿瘤的对比分析

目的探讨经腹腔镜辅助小切口手术在治疗原发性小肠肿瘤上的应用价值。方法回顾性分析2005年1月至2011年12月间经腹腔镜和开腹手术治疗的原发性小肠肿瘤患者的临床资料,其中腹腔镜组30例,开腹组24例,测定比较两组患者术前30min及术后6h、48h血清CRP水平,并对比两组手术时间、出血量、切口长度及术后排气时间、术后并发症发生率、住院时间及住院费用等。结果两组均顺利完成手术。腹腔镜组的平均手术时间、术后住院费用与开腹组差异无统计学意义（P〉0.05）。腹腔镜组术后6h、48h血清CRP水平均低于开腹组,术中出血量、切口长度、术后排气时间、术后并发症发生率、住院时间均优于开腹组,差异有统计学意义（P〈0.05）。结论腔镜辅助治疗原发性小肠肿瘤具有创伤小、出血少、恢复快等优点,较传统开腹手术优势明显。

Comparative study of laparoscopic auxiliary operation and traditional open surgery for primary small bowel tumors

Objective To explore the clinical value of laparoscopic auxiliary adding small incisions operation for primary small bowel tumors. Methods Laparoscopic auxiliary operation and traditional open surgery were performed for 54 patients with primary small bowel tumors from Jan 2005 to Dec 2011, including 30 cases of laparoscopy and 24 cases of laparotomy. The clinical data were collected and analyzed retrospectively, including the CRP level of serum at 30 min preoperative and 6 h , 48 h after injury , operative time, blood loss, incision length, exsufflation time, complications, hospital stay and hospitalization cost. Results There were no significant differences in serum CRP level at 30min preoperative( P > 0.05 ) .The level of CRP at 6 h , 48 h after injury in laparoscopic group were significantly less than open group( P < 0.05 ) The operative time of laparoscopic and open group was ( 1.5 ± 0.2 ) h and ( 1.6 ± 0.2 ) h , respectively ( P > 0.05 ). The blood loss was ( 40.7 ± 7.7 ) ml and ( 67.3 ± 14.5 ) ml , respectively ( P < 0.05 ). The incision length was ( 4.3 ± 0.6 ) cm and ( 8.6 ± 1.1 ) cm , respectively ( P < 0.05 ). The exsufflation time was ( 1.6 ± 0.7 ) d and ( 2.3 ± 0.8 ) d , respectively ( P < 0.05 ). The operative complication rate was 0 and 19.04 % ( P < 0.05 ). The hospital stay was ( 6.2 ± 0.8 )d and( 9.0 ± 1.6 )d ( P < 0.05 ). The hospitalization cost was ( 7621.7 ± 590.3 ) yuan and ( 7444.2 ± 472.2 ) yuan ( P > 0.05 ). Conclusions Laparoscopic auxiliary operation is not only effective for patients with advantages of less injury, less bleeding and more rapid recovery, but also it could help to clear diagnosis for small bowel tumors.