腹腔镜与开腹结直肠癌根治术临床疗效对比研究

目的:探讨腹腔镜结直肠癌根治术的安全性、有效性及可行性。方法:将大连大学附属中山医院腹腔镜外科2005年3月—2010年8月行腹腔镜结直肠癌根治术41例患者及同期行开腹结直肠癌根治术的41例患者临床资料进行对照研究。结果:两组术中、术后均无严重并发症和死亡病例,腹腔镜组有2例中转开腹手术。腹腔镜组手术时间长于开腹组(180.73±19.06)min vs(136.15±11.82)min,P=0.00]。腹腔镜组术中失血量明显少于开腹组(103.59±20.90)mL vs(201.34±28.96)mL,P=0.00]。清除的淋巴结总数量2组间差异无统计学意义(12.73±0.85)vs(13.1±1.49)枚,P=0.183]。直肠前切除远端切缘长度腹腔镜组明显长于开腹组(3.86±0.51)cm vs(3.48±0.51)cm,P=0.001]。腹腔镜组术后排气时间和下床时间明显早于开腹组(2.96±0.57)d vs(3.35±0.45)d,P=0.001](4.91±0.82)d vs(5.67±0.95)d,P=0.00]。腹腔镜组住院时间明显短于开腹组(10.62±0.43)d vs(14.54±0.97)d,P=0.00],但住院费用仍明显高于开腹组(3.59±0.71)×104元vs(2.42±0.41)×104元,P=0.00]。2组的3年生存率差异无统计学意义87.1%(27/31)vs 88.57%(31/35),P=0.286]。结论:腹腔镜技术在结直肠癌治疗上安全、可行,并具有创伤小、恢复快,痛苦少等优点,是目前结直肠癌的一种有效、安全且微创的治疗方式。

Comparison of clinical efficacy between laparascopic and open colonrectal carcinoma radical surgery for colorectal carcionoma

Objective： This research aims to explore safety,efficacy and feasibility for Colorectal Carcinoma treated by Laparoscopic surgery. Methods： In this research, the author collects and analyzes clinical statistics that were done in Laparoscopic ward in Affiliated Zhongshan Hospital of Dalian University from March, 2005 to October, 2010 and then compares 41 patients operated by means of Laparoscopic Colorectal Radical surgery with 41 patients operated by traditional Colonrectal Radical surgery. Results： There are no complications and cases of death caused by the operation during and after operations in the two groups and in the group of Laparoscopic surgery, there are two cases transfering open operation.The operation time of Laparoscopic surgery is longer than the group of open surgery（180.73 ± 19.06） vs （136.15 ± 11.82）min, which has significance（P=0.00）. Meanwhile, the blood loss of Laparoscopic group is obviously less than the group of open surgery （103.59 ± 20.901 mL vs （201.34 ± 28.96）mL, P=0.00]. The total number of lymph nodes eliminated has no differences between the two groups（12.73 ± 0.85） vs （13.1 ± 1.491, P=0.183]. The length of Distal incisal margin of Dixon surgery in Laparoscopic surgery is longer than the case in open surgery （3.86 ± 0.51 ） cm vs （3.48 ± 0.511cm, P=0.001]. Evacuation time and time of leaving the bed are earlier than the case in open surgery （2.96 ± 0.57）d vs （3.35 ± 045）d, P=0.001]（4.91 ± 0.821d vs （5.67 ± 0.95） d, P=0.00]. Length of staying in hospital in the group of Laparoscopic surgery is shorter than the case in open surgery （10.62 ± 0.43）d vs （14.54 ± 0.971d, P=0.00]. However, hospitalization expenses of Laparoscopic group are more than the other group （3.59 ± 0.71） × 10^4 vs （2.42 ± 0.41） × 10^4, P=0.00]. The 3 years survival rate in the two groups has no significance 87.1% （27/31） vs 88.57% （31/35）, P=0.2861]. Conelusimu Laparoscopic technology is safe and feasible in treating Colorectal Carcinoma and it has advantages of small trauma, quick recovery, few pains and so on. Laparoscopic surgery is at present a safe, efficient and mini-invasive way to treat Colorectal Carcinoma.