中华胃肠外科杂志
中華胃腸外科雜誌
중화위장외과잡지
CHINESE JOURNAL OF GASTROINTESTINAL SURGERY
2011年
6期
462-464
,共3页
张辉%李明%詹天成%姚云峰%彭亦凡%顾晋
張輝%李明%詹天成%姚雲峰%彭亦凡%顧晉
장휘%리명%첨천성%요운봉%팽역범%고진
手辅助腹腔镜手术%开腹手术%乙状结肠肿瘤%治疗效果
手輔助腹腔鏡手術%開腹手術%乙狀結腸腫瘤%治療效果
수보조복강경수술%개복수술%을상결장종류%치료효과
Hand-assisted laparoscopic surgery (HALS)%Open abdom%Sigmoidocolic neoplasms%Treatment outcomes
目的 对比手辅助腹腔镜技术和传统开腹技术在乙状结肠癌治疗中的安全性及围手术期疗效.方法 回顾性总结2009年1月至2010年6月在北京大学肿瘤医院结直肠外科施行乙状结肠癌根治性手术的115例患者的临床资料,其中手辅助腔镜(HALS组)62例,开腹组53例,对比两组手术的安全性及围手术期疗效.结果 HALS组与开腹组术中清扫淋巴结总数分别为(15.1±4.6)枚和(16.8±6.4)枚(P=0.163);两组的肿块切缘分别为(4.1±1.8)cm和(4.3±1.7)cm(P=0.601);两组手术时间分别为(122.4±32.0)min和(126.7±37.4)min(P=0.510).HALS组术中出血量(62.6±35.4)ml,明显少于开腹组的(168.9±137.1)ml(P=0.000);术后围手术期并发症发生率1.6%(1/62,为肺部感染1例),明显低于开腹组的11.3%(6/53,分别为吻合口瘘1例,腹盆腔感染2例和切口感染3例)(P=0.030);术后胃肠功能恢复快[(2.3±0.8)d比(3.3±1.1)d,P=0.000];术后平均住院日缩短[(8.8±2.7)d比(12.6±8.0)d,P=0.001].结论 手辅助腔镜用于乙状结肠癌切除术与开腹手术相比,可达到同样的近期根治效果,并具有安全、微创的优势.
目的 對比手輔助腹腔鏡技術和傳統開腹技術在乙狀結腸癌治療中的安全性及圍手術期療效.方法 迴顧性總結2009年1月至2010年6月在北京大學腫瘤醫院結直腸外科施行乙狀結腸癌根治性手術的115例患者的臨床資料,其中手輔助腔鏡(HALS組)62例,開腹組53例,對比兩組手術的安全性及圍手術期療效.結果 HALS組與開腹組術中清掃淋巴結總數分彆為(15.1±4.6)枚和(16.8±6.4)枚(P=0.163);兩組的腫塊切緣分彆為(4.1±1.8)cm和(4.3±1.7)cm(P=0.601);兩組手術時間分彆為(122.4±32.0)min和(126.7±37.4)min(P=0.510).HALS組術中齣血量(62.6±35.4)ml,明顯少于開腹組的(168.9±137.1)ml(P=0.000);術後圍手術期併髮癥髮生率1.6%(1/62,為肺部感染1例),明顯低于開腹組的11.3%(6/53,分彆為吻閤口瘺1例,腹盆腔感染2例和切口感染3例)(P=0.030);術後胃腸功能恢複快[(2.3±0.8)d比(3.3±1.1)d,P=0.000];術後平均住院日縮短[(8.8±2.7)d比(12.6±8.0)d,P=0.001].結論 手輔助腔鏡用于乙狀結腸癌切除術與開腹手術相比,可達到同樣的近期根治效果,併具有安全、微創的優勢.
목적 대비수보조복강경기술화전통개복기술재을상결장암치료중적안전성급위수술기료효.방법 회고성총결2009년1월지2010년6월재북경대학종류의원결직장외과시행을상결장암근치성수술적115례환자적림상자료,기중수보조강경(HALS조)62례,개복조53례,대비량조수술적안전성급위수술기료효.결과 HALS조여개복조술중청소림파결총수분별위(15.1±4.6)매화(16.8±6.4)매(P=0.163);량조적종괴절연분별위(4.1±1.8)cm화(4.3±1.7)cm(P=0.601);량조수술시간분별위(122.4±32.0)min화(126.7±37.4)min(P=0.510).HALS조술중출혈량(62.6±35.4)ml,명현소우개복조적(168.9±137.1)ml(P=0.000);술후위수술기병발증발생솔1.6%(1/62,위폐부감염1례),명현저우개복조적11.3%(6/53,분별위문합구루1례,복분강감염2례화절구감염3례)(P=0.030);술후위장공능회복쾌[(2.3±0.8)d비(3.3±1.1)d,P=0.000];술후평균주원일축단[(8.8±2.7)d비(12.6±8.0)d,P=0.001].결론 수보조강경용우을상결장암절제술여개복수술상비,가체도동양적근기근치효과,병구유안전、미창적우세.
Objective To compare the safety and efficacy perioperatively between hand-assisted laparscopic surgery (HALS) and conventional open sigmoidectomy.Methods Prospectively collected data on 115 patients with sigmoid colon cancer between January 2009 to June 2010 were analyzed. There were 62 patients in the HALS group and 53 in the conventional sigmoidectomy group (CS). Patient characteristics, operative parameters, and perioperative outcomes were compared.Results HALS patients were similar to CS patients in age(60.2 yrs vs. 63.4 yrs,P=0.163), gender (53.2% vs. 60.4% male, P=0.441), tumor size (4.7 cm vs. 5.3 cm, P=0.114) and tumor stage. The two groups were comparable in operative time[(122.4±2.0) min vs.(126.7±7.4) min, P=0.510], lymph node harvest (15.1±4.6 vs. 16.8±6.4,P=0.163), free margin length[(4.1±1.8) cm vs.(4.3±1.7) cm, P=0.601], and postoperative complications. However, HALS group had less intraoperative bleeding[(62.6±35.4) ml vs. (168.9±37.1) ml, P=0.000], shorter time to flatus[(2.3±0.8) d vs. (3.3±1.1) d, P=0.000], and shorter hospital stay[(8.8±2.7) d vs.(12.6±8.0) d, P=0.001]. Conclusions HALS results in similar short-term outcomes compared to conventional surgery. HALS is safe and minimally invasive.
