腹腔镜结直肠癌根治术治疗不同分期结直肠癌的短期疗效及安全性分析

目的 研究分析腹腔镜结直肠癌根治术治疗不同分期结直肠癌的短期疗效及安全性。 方法 选择2012年3月-2017年5月期间收治的50例结直肠癌患者,采用随机数字表法分为2组。其中25例行腹腔镜手术,归为观察组;25例行开腹手术,归为对照组。比较2组患者术中出血量、肛门排气时间、术后下床时间,以及肠梗阻、切口感染、尿路感染、吻合口瘘并发症发生情况。 结果 观察组患者术中出血量(35.6±16.1)ml显著少于对照组(56.2±22.7)ml,具有统计学意义(P<0.05);观察组肛门排气时间(2.7±0.3)d显著小于对照组(3.6±1.0)d,具有统计学意义(P<0.05);术后下床时间(10.8±2.5)d显著小于对照组(17.0±5.7)d,具有统计学意义(P<0.05);肠梗阻、切口感染、尿路感染、吻合口瘘并发症总发生率(8.0%)显著优于对照组(22.5%),具有统计学意义(P<0.05)。 结论 早期结直肠癌患者开展腹腔镜根治术进行治疗短期疗效显著,并且具有安全性,但对于进展时期的患者,要仔细术前评估,认真准备,选择合适的手术方式,才能提高术后疗效。 

Short-term efficacy and safety of laparoscopic radical resection for different stages of colorectal cancer

Objective To study the short-term efficacy and safety of laparoscopic radical surgery for different stages of colorectal cancer. Methods A total of 50 patients with colorectal cancer from March, 2012 to May, 2017 were randomly assigned observation group (25 cases) and control group (25 cases). The patients of the observation group underwent laparoscopic surgery, while the patients of the control group underwent open surgery. The amount of perioperative bleeding, the time to passing gas after surgery, the time to postoperative ambulation, and the complications such as intestinal obstruction, incision infection, urinary tract infection and anastomotic fistula were observed and compared between the two groups. Results The mean perioperative bleeding[(35.6±16.1) ml] of the observation group was less than that of the control group[(56.2±22.7) ml], the difference was statistical significance (P<0.05); the time to passing gas after surgery[(2.7±0.3)d] in the observation group was less than that in the control group (3.6±1.0)d, with statistical significance (P<0.05); the time to postoperative ambulation (10.8±2.5)d in the observation group was significantly less than the control group[(17.0±5.7)d], with statistical significance (P<0.05). The incidence of post-operative complication (6.0%) in the observation group was significantly lower than that in the control group (22.5%), the difference was statistical significance (P<0.05). Conclusion The laparoscopic radical surgery for the patients with early stage colorectal cancer is effective and safe. However, for patients with advanced stage, more work should be done such as careful preoperative assessment and detailed prepare and selecting suitable operative procedure, all of those could improve the effects of operations.