CAJ | 학술논문

目的评估腹腔镜结肠癌切除术的临床疗效及患者预后情况.方法对比2003年3月至2008年7月行腹腔镜结肠癌切除术的92例患者(腹腔镜组)和同期行开腹手术的285例患者(开腹组)的临床、病理资料；比较2组患者的5年局部复发率、总体生存率和无瘤生存率等术后长期随访结果.结果腹腔镜结肠癌切除术在减少术中出血量[50(50)ml]、加快术后消化道功能恢复方面[术后排气时间(3.0±1.0)d,术后进食时间(4.0±1.3)d]较开腹组均有显著优势(Z=-8.292,t=-6.475、-4.871,P＜0.01).腹腔镜组标本的远端切缘长度[(10±4)cm]较开腹组[(9±4)cm]明显延长(=3.527,P=0.000).腹腔镜结肠癌切除术和开腹结肠癌切除术患者的术后5年累积总体生存率分别为63.6％和61.8％；Ⅰ～Ⅲ期患者的5年累积局部复发率分别为8.7％和13.6％,无瘤生存率分别为69.5％和65.5％,差异均无统计学意义(P＞0.05).结论腹腔镜结肠癌切除术安全可行,其长期肿瘤生存结果与传统开腹手术近似.
목적 평고복강경결장암절제술적림상료효급환자예후정황.방법 대비2003년3월지2008년7월행복강경결장암절제술적92례환자(복강경조)화동기행개복수술적285례환자(개복조)적림상、병리자료；비교2조환자적5년국부복발솔、총체생존솔화무류생존솔등술후장기수방결과.결과 복강경결장암절제술재감소술중출혈량[50(50)ml]、가쾌술후소화도공능회복방면[술후배기시간(3.0±1.0)d,술후진식시간(4.0±1.3)d]교개복조균유현저우세(Z=-8.292,t=-6.475、-4.871,P＜0.01).복강경조표본적원단절연장도[(10±4)cm]교개복조[(9±4)cm]명현연장(=3.527,P=0.000).복강경결장암절제술화개복결장암절제술환자적술후5년루적총체생존솔분별위63.6％화61.8％；Ⅰ～Ⅲ기환자적5년루적국부복발솔분별위8.7％화13.6％,무류생존솔분별위69.5％화65.5％,차이균무통계학의의(P＞0.05).결론 복강경결장암절제술안전가행,기장기종류생존결과여전통개복수술근사.
Objective To evaluate the short-term outcomes and 5-year recurrence,overall survival,and disease-free survival of laparoscopic assisted surgery for colon cancer.Methods The clinical and pathologic data were compared between the patients who underwent colectomy during March 2003 to July 2008 and assigned in laparoscopic group (n =92) and open group (n =285) according the surgical approach.The 5-year overall survival,disease-free survival,and recurrence rate were analyzed for all patients who were followed-up for more than 36 months in either of the groups.Results The laparoscopic colectomy was associated with manifested less blood loss (50 (50) ml) (Z =-8.292,P ＜ 0.01),early return of bowel function (the evacuation time was (3.0 ± 1.0) days,and the meal time after operation was (4.0 ± 1.3) days) (t =-6.475 and-4.871,P ＜ 0.01),and longer length (cm) of distal resection margin((10 ±4)cm vs.(9 ±4)cm,t =3.527,P =0.000).The 5-year overall survival of the laparoscopic group and the open group were 63.6％ and 61.8％ respectively.The 5-year disease-free survival of the Ⅰ-Ⅲ stage patients in the laparoscopic group and the open group were 69.5％ and 65.5％ respectively,and the local recurrence were 8.7％ and 13.6％ (all P ＞ 0.05).Conclusion The laparoscopic colectomy for colon cancer is safe in short-term clinical results and non-inferior to the open colectomy in long-term oncological outcomes.