腹腔镜与开放手术治疗结肠癌的远期疗效比较..docxVIP

腹腔镜与开放手术治疗结肠癌的远期疗效比较 杨昕 【摘要】 目的 比较腹腔镜结肠癌根治术与开腹结肠癌根治术的远期疗效。方法 采用前瞻性非随机对照的方法比较腹腔镜结肠癌根治术与开腹结肠癌根治术在死亡率、转移复发率、总生存期及无瘤生存期方面的差异。结果 研究纳入155例腹腔镜手术患者(LA P 组)和 162 例开腹手术患者(O P 组)。 两组比较, 患者的围手术期临床病理资料无显著差异;患者的 5 年总生存率及无瘤生存率的差异无统计学意义;Ⅰ、Ⅱ、Ⅲ期患者的生存率及无瘤生存率的差异无统计学意义;患者的累积复发的差异无统计学意义。结论 腹腔镜结肠癌手术患者可达到与开放手术相当的远期生存率, 可安全地用于结肠癌的治疗, 并获得较好的临床效果。【关键词】 腹腔镜; 结肠癌; 结肠癌根治术; 远期疗效A non-randomized perspective investigation on long-term outcomes comparison between laparoscopic and open surgery in the treatment of colon cancerYang Xin【Abstract】 ObjectiveTo compare the long-term outcomes between laparoscopy and open surgery for coloncancers. Methods A non-randomized perspective investigation was performed to compare laparoscopic colectomy with open cloectomy on mortality rate, recurrence rate, total survival and cancer-free survival . Results One hundred and fifty-five cases of laparoscopic surgery (LAP group)and 162 cases of open surgery (OP group)without significant difference in peri-operative clinical data were recruited in the research.Therewas no statistical difference in total survival , caner-free survival and cumulative recurrence between LAP and OP groups .StageⅠ,Ⅱand Ⅲpatients between LAP and OP groups had no statistical difference in total survival and cancer-free survival , respectively .There was no significant difference on accumulative recurrence between the two groups. Conclusions Laparoscopic colectomy has the same long-term outcomes compared to traditional open colectomy in the treatment of colon cancer .【Key words】 laparoscopy;colon cancer;colectomy;long-term outcomes结肠癌是常见的恶性程度较高的消化系统恶性肿瘤之一 ,发病率在我国呈逐年上升趋势,手术切除是首选治疗手段。腹腔镜技术用于结肠疾病治疗在我国已有近 20 年历史[ 1] 。近年来腹腔镜结肠癌根治术发展迅速,具有创伤小、恢复快、住院时间短等优势[ 2 -3]。目前国内关于腹腔镜结肠癌根治术远期疗效的文献报道较少, 本文对2006年1月至2009年5月我院同期行腹腔镜结肠癌根治术和开腹结肠癌根治术的相关资料作一前瞻性非随机对照研究, 旨在探讨腹腔镜结肠癌根治术的远期疗效。1.资料和方法1.1临床资料 2006年1月至2016年5月在我院普外科行根治手术的结肠癌患者分为腹腔镜组(LAP 组)和开腹组(OP组)。腹腔镜手术和开放手术分别由同一名外科医生主刀完成。入组患者共计317例 , 其中LAP 组155例, OP组162例。所有患者术前均