腹腔镜与开腹结直肠癌手术短期效果的对比研究

目的:对比分析腹腔镜与开腹结直肠癌手术的短期效果。方法:回顾分析2001～2010年1 743例结直肠癌患者的临床资料,其中864例行腹腔镜手术8,79例行开腹手术。结果:相对开腹组,腹腔镜组切口小(5.5±1.8)cm vs.(23±3.5)cm,P<0.01;]失血量少(110±41)ml vs.(350±56)ml,P<0.01);]术后阿片类镇痛剂使用例数少(179 vs.261,P<0.01);首次下床活动时间早(1.9±0.9)天vs.(2.5±1.2)天,P<0.01;]肠道功能恢复快(2.5±0.6)天vs.(3.8±0.7)天,P<0.01;]术后住院时间短(6.5±1.3)天vs.(8.4±1.5)天,P<0.01;]术后并发症发生率低(15.7%vs.27.6%,P<0.01)。淋巴结清扫数量、标本切缘阳性率两组差异无统计学意义(P>0.05)。结论:腹腔镜结直肠癌手术安全可行,可取得与开腹手术相同的根治效果,且具有切口小、出血少、疼痛轻、术后住院时间短、并发症发生率低等优势,值得推广。

Comparative study of laparoscopic and open surgery for colorectal cancer:short-term results

Objective:To compare the short-term results in patients undergoing laparoscopic and open surgery for colorectal cancer.Methods:Clinical data of 864 colorectal cancer patients undergoing laparoscopic surgery and 879 patients treated with open surgery from 2001 to 2010 were analyzed retrospectively.Results:Compared with open surgery group,patients who underwent laparoscopic surgery were associated with smaller incision,less blood loss,less pethidine use,earlier postoperative ambulation,faster recovery of gastrointestinal function,shorter hospital stay and fewer postoperative complications(P<0.01).However,no significant difference was observed in positive surgical margin rate and the number of lymph nodes removed(P>0.05).Conclusions:Laparoscopic surgery is safe,feasible and has the same radical effects compared with conventional open surgery for colorectal cancer.It is associated with less trauma and faster recovery.