中华胃肠外科杂志
中華胃腸外科雜誌
중화위장외과잡지
CHINESE JOURNAL OF GASTROINTESTINAL SURGERY
2012年
1期
24-27
,共4页
孙艳武%池畔%林惠铭%卢星榕%黄颖%徐宗斌%黄胜辉
孫豔武%池畔%林惠銘%盧星榕%黃穎%徐宗斌%黃勝輝
손염무%지반%림혜명%로성용%황영%서종빈%황성휘
结肠肿瘤%腹腔镜%完整结肠系膜切除术%预后
結腸腫瘤%腹腔鏡%完整結腸繫膜切除術%預後
결장종류%복강경%완정결장계막절제술%예후
Colonic neoplasms%Laparoscopy%Complete mesocolic excision%Prognosis
目的 探讨腹腔镜与开腹结肠癌完整结肠系膜切除术(CME)疗效的差异.方法 收集2000年9月至2008年12月间福建医科大学附属协和医院外科同一组医师连续实施的273例结肠癌CME手术患者的临床资料,其中腹腔镜手术147例,开腹手术126例,比较两组术后的肿瘤根治性及远期疗效.结果 两组的近端切缘、远端切缘长度及淋巴结清扫数目的差异均无统计学意义(均P＞0.05).273例患者中,有251例(91.9％)接受了术后随访,中位随访时间50个月.腹腔镜组与开腹组的局部复发率分别为6.1％(9/147)和7.9％(10/126),远处转移率分别为23.8％(35/147)和16.7％(21/126),差异均无统计学意义(均P＞0.05).两组5年总生存率分别为69.4％和74.0％,5年无瘤生存率分别为68.5％和70.9％,差异均无统计学意义(均P＞0.05).结论 腹腔镜结肠癌CME手术能达到与开腹手术相同的肿瘤根治范围,有望成为结肠癌新的手术规范.
目的 探討腹腔鏡與開腹結腸癌完整結腸繫膜切除術(CME)療效的差異.方法 收集2000年9月至2008年12月間福建醫科大學附屬協和醫院外科同一組醫師連續實施的273例結腸癌CME手術患者的臨床資料,其中腹腔鏡手術147例,開腹手術126例,比較兩組術後的腫瘤根治性及遠期療效.結果 兩組的近耑切緣、遠耑切緣長度及淋巴結清掃數目的差異均無統計學意義(均P＞0.05).273例患者中,有251例(91.9％)接受瞭術後隨訪,中位隨訪時間50箇月.腹腔鏡組與開腹組的跼部複髮率分彆為6.1％(9/147)和7.9％(10/126),遠處轉移率分彆為23.8％(35/147)和16.7％(21/126),差異均無統計學意義(均P＞0.05).兩組5年總生存率分彆為69.4％和74.0％,5年無瘤生存率分彆為68.5％和70.9％,差異均無統計學意義(均P＞0.05).結論 腹腔鏡結腸癌CME手術能達到與開腹手術相同的腫瘤根治範圍,有望成為結腸癌新的手術規範.
목적 탐토복강경여개복결장암완정결장계막절제술(CME)료효적차이.방법 수집2000년9월지2008년12월간복건의과대학부속협화의원외과동일조의사련속실시적273례결장암CME수술환자적림상자료,기중복강경수술147례,개복수술126례,비교량조술후적종류근치성급원기료효.결과 량조적근단절연、원단절연장도급림파결청소수목적차이균무통계학의의(균P＞0.05).273례환자중,유251례(91.9％)접수료술후수방,중위수방시간50개월.복강경조여개복조적국부복발솔분별위6.1％(9/147)화7.9％(10/126),원처전이솔분별위23.8％(35/147)화16.7％(21/126),차이균무통계학의의(균P＞0.05).량조5년총생존솔분별위69.4％화74.0％,5년무류생존솔분별위68.5％화70.9％,차이균무통계학의의(균P＞0.05).결론 복강경결장암CME수술능체도여개복수술상동적종류근치범위,유망성위결장암신적수술규범.
Objective To explore the differences in long-term outcomes between laparoscopic and open complete mesocolic excision (CME) for colon cancer.Methods A total of 273 patients with colon cancer who underwent CME at the Fujian Medical University Union Hospital from September 2000 to December 2008 were divided into laparoscopic(LP,n=147) and open(OP,n=126) groups in a non-random manner.The oncologic and long-term outcomes were compared.Results No significant differences were seen in the length of distal and proximal margin,and number of lymph nodes (all P＞ 0.05).Median postoperative follow up was 50 months.Local regional recurrence rates (LP 6.1％ vs.OP 7.9％) and distal metastasis rates (LP 23.8％ vs.OP 16.7％) were similar between the two groups(all P＞0.05).The 5-year overall survival rates (LP 69.4％ vs.OP 74.0％,P=0.840) and 5-year disease-free survival rates (LP 68.5％ vs.OP 70.9％,P=0.668) between the two groups were not statistically different.Conclusions Laparoscopic CME has the same oncologic clearance effects compared with open CME for colon cancer.It might become a new standardized surgery for colon cancer.
