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中国癌症防治杂志

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腹腔镜结直肠癌手术的临床研究

陈建思;刘圣文;覃宇周;杨华伟;   

  1. 广西医科大学肿瘤医院;柳州钢铁集团公司职工医院;
  • 收稿日期:2009-09-25 修回日期:2009-09-25 出版日期:2009-09-25 发布日期:2009-09-25

Clinical survey of laparoscopic surgery on colorectal carcinoma

1CHEN Jian-si,2LIU Sheng-wen,QIN Yu-zhou,et al.   

  1. (1Cancer Hospital of Guangxi Medical University,2Hospital of Liuzhou Iron and Steel Group,Guangxi 530021,China
  • Received:2009-09-25 Revised:2009-09-25 Online:2009-09-25 Published:2009-09-25

摘要: 目的评价腹腔镜结直肠癌手术的优点和存在不足之处。方法对2002年1月至2006年10月完成的22例腹腔镜结直肠癌手术者与同期具可比性的40例传统开腹结直肠癌手术的资料进行比较。结果腹腔镜组的术中出血量、肠功能恢复时间、尿管留置时间、下床活动时间和人均镇痛次数等均明显少于传统手术组(P<0.05)。腹腔镜组手术时间、手术费和住院总费用等明显多于传统手术组(P<0.05)。两组手术切除的肿块大小、结直肠标本长度、直肠肿瘤远端长度和清扫淋巴结数目的差异均无统计学意义(P>0.05)。手术并发症发生率分别为9.1%和32.5%,差异有统计学意义(P<0.05)。随访时间6~51个月,两组局部复发率、转移率、病死率均无统计学意义(P>0.05)。结论腹腔镜结直肠癌根治术可以达到与传统结直肠癌根治术同样的根治效果,具有创伤小、安全、可行的优点。但手术时间较长,费用较高。

关键词: 结直肠癌, 腹腔镜

Abstract: Objective To evaluate the advantages and disadvantages of laparoscopic surgery on colorectal cancer.Methods Clinical records from 22 cases of colorectal carcinoma treated by laparoscopic operation from January 2002 to October 2006 were studied retrospectively.The control group included 40 comparable cases that were treated by conventional surgery in the same period.Results In laparoscopic group,intraoperative blood loss,bowel function restoration time,urinary catheter removal time,out-of-bed activity time and postoperative anodyne consumption were significantly higher than those in conventional group respectively(P<0.05),while the longer mean operation time and higher hospitalization costs were observed in the laparoscopic group.No significant differences were detected between the two groups in tumor size,colorectum specimen length,distal margin and lymph node harvest.The complication rates in the two groups were 9.1% and 32.5% respectively,and the difference was statistically significant(P<0.05).Between the two groups,there were no significant differences in the rates of local recurrence,distant metastasis and mortality after operation.Conclusions Laparoscopic surgery has the same effect as traditional radical operation on colorectal cancer.It is a safe and feasible technique with less surgical trauma and quicker recovery,while with longer mean operation time and higher medical expenses.

Key words: Colorectal neoplasm, Laparoscopy, Operation