腹腔镜与开腹结肠癌根治术远期疗效比较研究

目的:评价并对比腹腔镜与开腹结肠癌根治术远期疗效的差异。方法:回顾分析2008年4月至2011年12月由同一手术组医师收治的68例结肠癌根治术患者的临床资料,根据所行术式分为腹腔镜组(n=31)与开腹组(n=37),采用前瞻性非随机对照法对比两组患者术中失血量、术后住院时间、转移复发率、术后远期并发症、5年累计存活率等指标。结果:腹腔镜组手术时间与开腹组相似(P=0.457),但术中失血量少(P=0.038),术后住院时间短(P=0.031),差异有统计学意义(P<0.05);两组患者除粘连性肠梗阻外,在远处转移、局部复发及切口疝、切口种植方面差异均无统计学意义(P>0.05);两组患者5年总存活率差异无统计学意义(P=0.516)。结论:腹腔镜结肠癌根治术能取得开腹手术的远期疗效,可安全地用于结肠癌的治疗,但腹腔镜术中失血量少、术后住院时间短,且远期并发症少,值得推广应用。

Comparative study on long term efficacy of laparoscopic and open radical resection of colon cancer

Objective:To compare the long term efficacy of laparoscopic and open radical resection of colon cancer.Methods:The clinical data of 68 patients suffered from colon cancer who were admitted and treated by the same operation group from Apr.2008 to Dec.2011 were analyzed retrospectively.The 68 patients were divided into laparoscopic group(n=31) and open group(n=37),and the introperative blood loss,length of postoperative hospital stay,metastasis and recurrence rates,long term complications and five-year survival rates of the 2 groups were prospectively non-randomly compared.Results:Though the operation duration of laparoscopic group was similar with that of open group(P=0.457),less blood loss(P=0.038) and shorter hospital stay(P=0.031) were observed in laparoscopic group.There was not significant differences in distant metastasis,local recurrence,incisional hernia,incision implantation(P>0.05) and five-year survival rates(P=0.516).The difference of adhesive intestinal obstruction was statistically significant.Conclusions:Laparoscopic radical resection of colon cancer is as safe and effective as open surgery,has the advantages of less blood loss,shorter hospital stay and fewer long term complications,so it is worthy of promotion.