腹腔镜结直肠癌根治术与开腹手术近远期疗效的比较.doc

腹腔镜结直肠癌根治术与开腹手术近远期疗效的比较 　　作者：任镜清,刘建伟,刘少杰,黄时杰,陈志棠　　作者单位：510220 广州,暨南大学第四附属医院 广州市红十字会医院普外科 　　【摘要】目的比较腹腔镜结直肠癌根治术与开腹手术的近远期临床疗效。方法回顾性分析1998 年1月至2008年12月在本院行结直肠癌根治性手术的375例患者的临床病理资料,根据其手术方式分为腹腔镜手术组(72例)和开腹手术组(303例),比较两组的一般资料。手术时间。出血量。淋巴结数目。肛门排气时间。术后住院时间。术后并发症及术后无瘤生存率。结果 腹腔镜组和开腹手术组资料具有可比性,在出血量(121.81 ml vs 160.41 ml)。肛门排气时间(3.03 d vs 3.90 d)。术后住院时间(12.03 d vs 15.69 d)腹腔镜组优于开腹手术组(P均 0.05),两组手术时间(209.79 min vs 198.50 min)。淋巴结数目(10.82 vs 9.48)及术后并发症发生率(23.61% vs 26.07%)差异无统计学意义,腹腔镜组术后3。5年无瘤生存率分别为67.7%。60.3%,开腹手术组分别为66.8%。53.5%,两组比较差异无统计学意义,按病理分期分层分析两组的术后无瘤生存率仍差异无统计学意义。结论 腹腔镜结直肠癌根治术近期疗效优于开腹手术,远期疗效与开腹手术相当,腹腔镜结直肠癌根治术具有可行性。 　　【关键词】 结直肠癌; 腹腔镜; 手术; 疗效 　　【Abstract】 Objective To compare the short-term and long-term outcomes of laparoscopic surgery versus open surgery for colorectal cancer. Methods The clinicopathologic factors and follow-up data of 375 cases with colorectal cancer after curative resection from January 1998 to December 2008 were analyzed retrospectively, the clinicopathologic factors, operation time, blood loss, number of removed lymph nodes, recovery of bowel function, hospital stay, morbidity and recurrence were compared between laparoscopic surgery group and open surgery group. Results There was no difference in clinicopathologic factors between the two groups, blood loss (121.81 ml vs. 160.41 ml), recovery of bowel function (3.03 d vs. 3.90 d), hospital stay (12.03 d vs. 15.69 d) were better in laparoscopic surgery group than in opens- urgery group. There was no difference in operation time (209.79 min vs. 198.50 min), number of remo ved lymph nodes (10.82 vs. 9.48) and morbidity (23.61% vs. 26.07%) between the two groups. The 3-year and 5-year disease-free survival in laparoscopic surgery group were 7.7% and 60.3%, which were 66.8% and 53.5% in open surgery group, there was still no difference in disease-free survival when stratification for stage. Conclusion The short-term outcomes of laparoscopic surgery are better than these of open surgery for