吴松,杨成林
WU Song,YANG Chenglin

• 1:平利县医院
• 2:安康市中心医院
• 3:安康职业技术学院附属医院

摘要(Abstract)：

目的:探讨腹腔镜手术在结肠癌的治疗中的远期疗效。方法:179例结肠癌患者,按照手术方法分为观察组和对照组,观察组采用腹腔镜手术,对照组采用开放手术,比较两组结肠癌手术用时、术中出血量、通气时间、进食时间及清除的淋巴数,观察随访13~61个月的肿瘤局部复发、远处转移、远期并发症及患者3年和5年生存率;评估肿瘤分期与远期疗效的关系。结果:两组结肠癌患者除手术用时、淋巴清除数目外,术中出血量、通气时间及进食时间比较观察组优于对照组(P<0.05);两组结肠癌患者远期疗效比较,差异无统计学意义(P>0.05);结肠癌Ⅲ、Ⅳ期患者局部复发、远处转移、远期并发症均高于Ⅰ、Ⅱ期患者,3年和5年生存率显著低于Ⅰ、Ⅱ期患者,差异有统计学意义(P<0.05)。结论:腹腔镜手术治疗结肠癌远期疗效与开放手术相当,术后的预后与肿瘤分期有关。
Objective: To investigate the long-term efficacy of laparoscope operation in the treatment of colon cancer. Methods: A total of 179 patients with colorectal cancer was divided into LS group and OS group according to the operation method. LS group was treated with laparoscopic operation,OS group was treated with open operation,and treatment results were evaluated. Comparing surgery time,blood loss,duration of ventilation,feeding time and lymphocyte count; observing follow-up visit local tumor recurrence in 13 to 61 months,3 years and 5 years survival rate; evaluating the relationship between tumor staging and long term efficacy. Results: In LS group,the amount of intraoperative bleeding,duration of ventilation,the time of food intake were lower than OS group( P < 0. 05); long term efficacy comparison showed no statistical significance( P > 0. 05). The incidences of local recurrence,distant metastasis,and long-term complication patients with stage Ⅲ and Ⅳ was significantly higher than those of patients with stage Ⅰ and Ⅱ,and the survival rates of 3 years and 5 years were significantly lower than those in patients with stage Ⅰ and Ⅱ,and the difference was statistically significant( P < 0. 05). Conclusion: In the treatment of colon cancer,the laparoscope operation is safe and effective,tumor staging is closely related to the prognosis of patients.

关键词(KeyWords)： 腹腔镜;结肠肿瘤;远期疗效;手术后并发症
laparoscope;colorectal cancer;long term curative effect;postoperative complications

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 吴松,杨成林
WU Song,YANG Chenglin

DOI: 10.19367/j.cnki.1000-2707.2015.11.035

参考文献(References)：

• [1]康建省,刘国超,乔占英,等.腹腔镜与开腹手术治疗结肠癌远期疗效的Meta分析[J].腹腔镜外科杂志,2011(10):737-741.
• [2]张东秀.腹腔镜胃十二指肠溃疡穿孔修补术与开腹术疗效比较[J].贵阳医学院学报,2013(6):657-659.
• [3]朱殊,陈环.腹腔镜与开腹结肠癌根治术的对比研究[J].中国现代普通外科进展,2013(8):651-653.
• [4]白洪祥,刘现立.腹腔镜下结肠癌根治术安全性及对患者术后胃肠道功能的影响[J].中国老年学杂志,2014(14):4039-4040.
• [5]王大广,张洋,何亮,等.腹腔镜保留左半结肠血管的直肠癌第3站淋巴结清扫术[J].中华消化外科杂志,2014(7):575-577.
• [6]张辉,李明,詹天成,等.乙状结肠癌根治术手辅助腹腔镜与开腹手术围手术期疗效的对比[J].中华胃肠外科杂志,2011(6):462-464.
• [7]赵明利,薛琪,李雅男,等.腹腔镜结肠癌术后早期口服肠内营养的临床观察[J].中华胃肠外科杂志,2013(11):1041-1044.
• [8]孙跃民,解亦斌,郑朝旭,等.腹腔镜左半结肠切除38例临床分析[J].中国医刊,2014(6):24-26.
• [9]赵丽瑛,王亚楠,余江,等.腹腔镜结肠癌切除术对比开腹手术的安全性和长期生存分析[J].中华外科杂志,2013(4):314-319.
• [10]沈荐,李敏哲,杜燕夫,等.腹腔镜直肠癌前切除术中保留左结肠动脉与否的临床对照研究[J].中国微创外科杂志,2014(1):22-24.

文章评论(Comment)：