腹腔镜与开腹右半结肠切除术根治结肠癌围手术期比较

目的:探讨腹腔镜右半结肠切除术的可行性及近期疗效。方法:回顾分析2004年5月至2009年2月行腹腔镜右半结肠癌根治术22例及开腹右半结肠癌根治术17例患者的临床资料,比较两组患者手术及术后情况。结果:腹腔镜组与开腹组手术时间分别为(199.55±32.3)min、(144.71±28.97)min,差异无统计学意义(P=0.099);切口长度分别为(5.55±0.74)cm、(19.24±2.67)cm,差异有统计学意义(P=0.00);出血量分别为(53.41±43.08)ml、(138.24±65.02)ml,差异有统计学意义(P=0.024);淋巴结清除数分别为(12.73±2.16)枚、(13.12±2.55)枚,差异无统计学意义(P=0.41);术后胃肠道功能恢复时间分别为(23.18±7.79)h、(64.18±13.07)h,差异有统计学意义(P=0.02)。结论:腹腔镜右半结肠癌根治术安全可行,具有患者创伤小,术后康复快的优点,根治效果可达到开腹手术的水平。

Perioperative comparison of laparoscopic and open right hemicolectomy for colon carcinoma

Objective:To investigate the feasibility and short-term therapeutic effect of laparoscopic hemicolectomy for colon carcinoma.Methods:The clinical data of 22 cases underwent laparoscopic right hemicolectomy for colon carcinoma and 17 cases underwent open right hemicolectomy for colon carcinoma from May 2004 to Feb.2009 was retrospectively analyzed.Their perioperative conditions were analyzed.Results:The mean operative time of laparoscopic group and open group was(199.55±32.3)min and(144.71±28.97)min respectively,however,the difference between two groups was insignificant(P=0.099);The incision length of laparoscopic group was obviously shorter than that of open group[(5.55±0.74)cm vs.(19.24±2.67)cm](P=0.00);And the intra-operative blood loss of laparoscopic group was obviously less than that of open group [(53.41±43.08)ml vs.(138.24±65.02)ml](P=0.024);Moreover,there was no significant difference between the number of cleared lymph nodes [(12.73±2.16) vs.(13.12±2.55)](P=0.41);The gastrointestinal function of laparoscopic group recovered more quickly than open group[(23.18±7.79)h vs.(64.18±13.07)h](P=0.02).Conclusions:The laparoscopic right hemicolectomy for colon carcinoma is safe and effective.It has advantages of less blood loss and trauma,earlier postoperative recovery,and similar radical effect as laparotomy.