CAJ | 학술논문

目的：对比手辅助腹腔镜技术（HALS）与开腹手术在乙状结肠癌治疗中的安全性及疗效。方法前瞻性入组2010年1月至2013年6月间北京大学肿瘤医院结直肠外科收治的291例乙状结肠癌患者，非随机分为HALS组（200例）和开腹组（91例），对比两组患者的手术安全性及疗效。结果两组患者手术时间、术中淋巴结清扫数目和术后并发症发生率差异均无统计学意义（均P＞0．05）。但HALS组患者较开腹组术中出血量明显减少[（57．9±28．3） ml比（82．5±47．6） ml， P＝0．000]，术后排气时间明显加快[（3．0±1．4） d比（3．3±0．9） d， P＝0．000]，术后住院时间明显缩短[（7．3±4．2） d比（8．9±4．4） d， P＝0．004]。术后随访6月至3年，两组患者总生存时间和无病生存时间的差异均无统计学意义（P＝0．391和P＝0．167）。结论 HALS技术用于乙状结肠癌根治术可达到与开腹手术相同的治疗效果，且微创优势明显。
목적：대비수보조복강경기술（HALS）여개복수술재을상결장암치료중적안전성급료효。방법전첨성입조2010년1월지2013년6월간북경대학종류의원결직장외과수치적291례을상결장암환자，비수궤분위HALS조（200례）화개복조（91례），대비량조환자적수술안전성급료효。결과량조환자수술시간、술중림파결청소수목화술후병발증발생솔차이균무통계학의의（균P＞0．05）。단HALS조환자교개복조술중출혈량명현감소[（57．9±28．3） ml비（82．5±47．6） ml， P＝0．000]，술후배기시간명현가쾌[（3．0±1．4） d비（3．3±0．9） d， P＝0．000]，술후주원시간명현축단[（7．3±4．2） d비（8．9±4．4） d， P＝0．004]。술후수방6월지3년，량조환자총생존시간화무병생존시간적차이균무통계학의의（P＝0．391화P＝0．167）。결론 HALS기술용우을상결장암근치술가체도여개복수술상동적치료효과，차미창우세명현。
Objective To compare the perioperative safety and efficacy between hand-assisted laparoscopic surgery (HALS) and conventional open sigmoidectomy. Methods A total of 291 patients with sigmoid colon cancer who underwent surgery in our hospital from January 2010 to June 2013 were seperated into (HALS) group (n=200) and conventional open surgery (COS) group (n=91) with a non-randomized method. The perioperative safety and efficacy of two groups and perioperative outcomes were compared. Results These two groups were comparable in operative time, lymph node harvest, and postoperative complications. However, HALS group had less intraoperative bleeding [(57.9±28.3) ml vs. (82.5±47.6) ml, P=0.000], shorter time to flatus[(3.0±1.4) d vs. (3.3±0.9) d, P=0.000], and shorter hospital stay[(7.3±4.2) d vs. (8.9±4.4) d, P=0.004]. There werer no significant differences in overall survival time and disease-free survival time between the two groups during 6 months to 3 years follow-up. Conclusions HALS results in similar outcomes of conventional open surgery for sigmoidectomy with the advantage of minimal invasiveness.