CAJ | 학술논문

[目的]探讨结直肠癌腹腔镜根治术的可行性和安全性.[方法]回顾我院2006年1月至2011年11月成功施行手术治疗的96例结直肠癌患者的临床资料,其中腹腔镜结直肠癌根治手术45例,传统开腹结直肠癌根治手术51例.对比两组患者的手术时间、术中出血量、切除肠管长度、淋巴结获取数和术后胃肠功能恢复时间、术后留院时间以及局部复发、远处转移等指标.[结果]两组患者术前ASA评分、并发症、病理分级差异无统计学意义(P＞0.05).腹腔镜组术中出血量明显少于开腹组[(53.4±19.7) ml vs.(145.0±79.4)ml,P＜0.05],手术时间开腹组明显短于腹腔镜组[(174.2±40)minvs.(245.6±87) min,P＜0.05]；与开腹组相比,腹腔镜组术后肛门排气时间[(2.2±0.5)dvs.(3.4±1.0)d,P＜0.05]、进食时间[(4.1±1.1)dvs.(6.1±1.6)d,P＜0.05]及术后留院时间[(11.7±2.3)dvs.(18.8±13.9)d,P＜0.05]显著缩短；手术切除肠管长度、术中淋巴结获取数以及术后相关并发症两组差异无统计学意义(P＞0.05).随访1 ～36个月,平均18个月,两组局部复发和远处转移差异无统计学意义(P＞0.05).[结论]腹腔镜结直肠癌根治术具有良好的安全性及可行性,具有出血少、康复快、住院时间短等优势,可在有一定腹腔镜手术基础的医院实行.
[목적]탐토결직장암복강경근치술적가행성화안전성.[방법]회고아원2006년1월지2011년11월성공시행수술치료적96례결직장암환자적림상자료,기중복강경결직장암근치수술45례,전통개복결직장암근치수술51례.대비량조환자적수술시간、술중출혈량、절제장관장도、림파결획취수화술후위장공능회복시간、술후류원시간이급국부복발、원처전이등지표.[결과]량조환자술전ASA평분、병발증、병리분급차이무통계학의의(P＞0.05).복강경조술중출혈량명현소우개복조[(53.4±19.7) ml vs.(145.0±79.4)ml,P＜0.05],수술시간개복조명현단우복강경조[(174.2±40)minvs.(245.6±87) min,P＜0.05]；여개복조상비,복강경조술후항문배기시간[(2.2±0.5)dvs.(3.4±1.0)d,P＜0.05]、진식시간[(4.1±1.1)dvs.(6.1±1.6)d,P＜0.05]급술후류원시간[(11.7±2.3)dvs.(18.8±13.9)d,P＜0.05]현저축단；수술절제장관장도、술중림파결획취수이급술후상관병발증량조차이무통계학의의(P＞0.05).수방1 ～36개월,평균18개월,량조국부복발화원처전이차이무통계학의의(P＞0.05).[결론]복강경결직장암근치술구유량호적안전성급가행성,구유출혈소、강복쾌、주원시간단등우세,가재유일정복강경수술기출적의원실행.
[Objective]To study the feasibility and safety of laparoscopic radical resection of colorectal cancer.[Methods]The clinical data of 45 patients underwent laparoscopic colorectal surgery were compared with the data of 51 patients treated by traditional surgery in our department from January 2006 to November 2011.[Results] There were no severe complications and death occurred in both groups.The ASA score,complications and pathologic stage of the two groups had no statistically significant difference( P ＞ 0.05).The intra-operative blood loss of the laparoscopic group was(53.4 ± 19.7) ml.It was obviously less than that in open group [ ( 145.0 ±79.4) ml,P ＜ 0.01].The mean operation time of laparoscopic group and open group were ( 245.6 ± 87.0) min and ( 174.2 ±40.1 ) min respectively,there was a statistical difference between them( P ＜ 0.01 ).The length of the recovery time of gastrointestinal function and hospital stays of laparoscopic group were significantly shorter than open group ( P ＜0.05 ).There was no statistical difference in the number of cleared lymph nodes and the length of the bowel resection between two groups( P ＞ 0.05 ).During following-up of 1-36 months ( mean 18 months ),there was no significant difference in local recurrence and distant metastasis between two groups.[Conclusions]Laparoscopic radical resection of colorectal cancer is safety and feasibility.