腹腔镜全结肠系膜切除术21例回顾分析

目的:探讨腹腔镜全结肠系膜切除术(complete mesocolic excision,CME)的可行性、安全性及有效性。方法:回顾分析2012年6月—2014年6月在江苏省常熟市第一人民医院普外科行腹腔镜CME的21例患者(腔镜组)与行结肠癌开腹手术的27例患者(开腹组)的临床资料。比较2组患者术中出血量、淋巴结清扫数目,术后开始下床时间、肛门排气时间、进半流食时间,住院天数、住院费用和并发症情况。结果:腔镜组与开腹组性别、年龄、分化程度、TNM分期、淋巴结清扫数目、并发症发生率差异均无统计学意义(P0.05);腔镜组术中出血量、术后开始下床时间、肛门排气时间、进半流食时间、住院天数、住院费用均少于或早于开腹组(P0.05、0.01)。结论:腹腔镜CME安全、可行、有效,较开腹手术存在多方面的优势。

Retrospective Analysis of Laparoscopic Complete Mesocolic Excision:a Report of 21 Cases

Objective：To explore the feasibility,safety and effectiveness of laparoscopic complete mesocolic excision （CME）. Methods：A retrospective analysis was done on clinical data of 21 patients who underwent laparoscopic and 27 patients who un-derwent open surgery from Jun 2012 to Jun 2014 in Changshu First People＇s Hospital.Blood loss,numbers of removed lymph nodes,time of getting out of bed,anal exhaust time,time of eating half-flow food,hospital stay,hospital costs,complications were compared between the two groups.Results：No significant difference was found in gender,age,degree of differentiation, TNM stage,numbers of removed lymph nodes and the complication rates （P 〉0.05）between the two groups.The blood loss, beginning time of getting out of bed,anal exhaust time,time of eating half-flow food,hospital stay,hospital cost in laparoscopic group were less or earlier than those in the open group （P 〈0.05,0.01）.Conclusions：Laparoscopic CME is safe,feasible and effective,and has many advantages than open surgery.