腹腔镜与开放手术治疗结肠癌的远期疗效比较

目的分析腹腔镜与开放手术治疗结肠癌远期疗效存在的差异。方法随机选取2010年1月~2013年1月由同一手术组医师实施的150例结肠癌根治术患者的临床资料进行回顾性分析,根据手术方式的不同分为腹腔镜手术组(n=77)和开腹手术组(n=73),分析两组患者2年和5年生存率、局部复发和远处转移情况、术后随访期间(6个月~5年)的并发症。结果腹腔镜手术组2年生存率为79.22%,5年生存率为31.17%;开腹手术组2年生存率为79.45%,5年生存率为30.14%,两组比较差异无统计学意义(P0.05)。腹腔镜手术组术后转移复发率为20.78%,开腹手术组术后转移复发率为17.81%,两组比较差异无统计学意义(P0.05)。腹腔镜手术组随访期间并发症发生率为5.19%,与开腹手术组(17.81%)比较,差异有统计学意义(P0.05)。结论采用腹腔镜术式治疗结肠癌与开腹手术的远期疗效无显著差异,但腹腔镜手术术后远期并发症少,具有一定优势,值得进一步研究和推广。

Long-term effect of laparoscopy and laparotomy operation in patients with colon cancer

Objective To investigate the difference on long-term effect of laparoscopy and laparotomy operation in patients with colon cancer. Methods Medical records of 150 patient who nderwent radical operation of colon cancer by the same team of surgeons in our hospital from January, 2010 to January, 2013 were randomly selected and reviewed retrospectively. Patients were divided into laparoscopy operation group (77 patients) and laparotomy operation group (73 patients) according to the type of operation. Rates of 2-year and 5-year survival, the incidence of local recurrence and distant metastasis as well as the incidence of complications during follow-up period (6 months to 5 years). Results Rates of 2-year and 5-year survival in laparoscopy operation group were 79.22% and 31.17% respectively. Rates of 2-year and 5-year survival in laparotomy operation group were 79.45% and 30.14% respectively. There were no statistical differences between two groups (P>0.05). The incidence of recurrence and metastasis in laparoscopy operation group was 20.78%, which was not statistically different from that in laparotomy operation group (17.81%) (P>0.05). The incidence of complications during follow-up period in laparoscopy operation group was 5.19%, which was statistically different from that in laparotomy operation group(17.81%)(P<0.05). Conclusion There was no significant difference between laparoscopy and laparotomy operation in patients with colon cancer. However, there were fewer complications after laparoscopy operation. Laparoscopy operation enjoyed advantages over laparotomy operation and it was worth further study and promotion.