CAJ | 학술논문

目的比较分析应用腹腔镜下进展期结直肠癌根治术的可行性、肿瘤根治性及临床疗效.方法分析广东省人民医院2006年6月至2007年12月收治的191例进展期结直肠癌患者的临床资料.结果根据随机数字表进行分组.98例接受腹腔镜手术,93例接受传统开腹手术.腹腔镜手术组中5例(5.1%)中转开腹手术.腹腔镜手术组术中出血量为(87.2±27.1)ml,明显少于传统开腹手术组的(279.5±189.4)ml(P=0.011).腹腔镜手术组48 h内肛门排气和离床活动的患者分别占37.8%(37/98)和30.6%(30/98),明显高于传统开腹手术组的6.5%(6/93,P=0.000)和3.2%(3/93,P=0.000).传统开腹手术组术后需要使用麻醉性止痛药止痛的患者占13.3%(13/98),明显高于腹腔镜手术组的61.3%(57/93)(P=0.000).腹腔镜手术组平均总住院时间为(8.9±5.9)d.明显低于传统开腹手术组(12.1±7.6)d(P=0.036).两组其他临床凶素(性别、年龄、肿瘤部位和TNM分期、手术切除方式、收获淋巴结数目、术后并发症发生率等)比较,差异无统计学意义(P>0.05).结论进展期结直肠癌行腹腔镜根治术安全可行,能达到与开腹同样的效果.
목적 비교분석응용복강경하진전기결직장암근치술적가행성、종류근치성급림상료효.방법 분석광동성인민의원2006년6월지2007년12월수치적191례진전기결직장암환자적림상자료.결과 근거수궤수자표진행분조.98례접수복강경수술,93례접수전통개복수술.복강경수술조중5례(5.1%)중전개복수술.복강경수술조술중출혈량위(87.2±27.1)ml,명현소우전통개복수술조적(279.5±189.4)ml(P=0.011).복강경수술조48 h내항문배기화리상활동적환자분별점37.8%(37/98)화30.6%(30/98),명현고우전통개복수술조적6.5%(6/93,P=0.000)화3.2%(3/93,P=0.000).전통개복수술조술후수요사용마취성지통약지통적환자점13.3%(13/98),명현고우복강경수술조적61.3%(57/93)(P=0.000).복강경수술조평균총주원시간위(8.9±5.9)d.명현저우전통개복수술조(12.1±7.6)d(P=0.036).량조기타림상흉소(성별、년령、종류부위화TNM분기、수술절제방식、수획림파결수목、술후병발증발생솔등)비교,차이무통계학의의(P>0.05).결론 진전기결직장암행복강경근치술안전가행,능체도여개복동양적효과.
Objective To evaluate the feasibility, the radicalness and efficacy of laparoscopy for advanced colorectal cancer. Methods From June 2006 to December 2007, laparoscopic surgery and open radical resection were performed in 191 eases of colorectal cancer. The curative effect and clinical data were collected and analyzed. Results The patients were randomized to two groups, 98 patients underwent laparoscopie surgery and 93 open operation. Five cases (5.1%) were converted to open surgery in laparoscopic surgery group. The average intraoperative blood loss of open surgery group was (279.5±189.4) ml, while that of laparoscopic surgery group was (87.2±27.1) ml, the difference between the two groups was statistically significant (P=0.011). Within postoperative 48 hours, the intestinal function and early mobile physical activity were restored in 37.8% (37/98) and 30.6% (30/ 98) patients of laparoseopie surgery group, while in 6.5%(6/93, P=0.O00) and 3.2% (3/93, P=0.000) patients of open surgery group, the differences between two groups were statistically significant.The average hospital stay of laparoscopic surgery group was (8.9±5.9) d, whereas open surgery group (12.1±7.6) d, the difference was statistically significant (P=0.036). No significant differences were found between the two groups in gender, age, tumor location, resection range of surgery, TNM staging,post-operative complication and lymph node harvest (P>0.05). Conclusions Laparoscopic surgery is feasible for the patients with advanced colorectal cancer. The radicalness of laparoscopic surgery is similar to that of open surgery, and laparoscopie surgery can provide less intraoperative blood loss, better intestinal function restoration, early mobile physical activity and shorter hospital stay.