摘要
目的探讨腹腔镜手术联合全结肠系膜切除术(CME)对右半结肠癌根治术的可行性、安全性、短期和长期肿瘤预后的评价。方法回顾性分析2008年1月至2013年5月间收治的66例行根治手术的右半结肠癌病例资料,其中26例接受腹腔镜手术(腹腔镜组),40例接受开腹手术(开腹组),比较两组患者的临床病理和生存资料。结果两组患者的基本临床资料差异无统计学意义。腹腔镜组的术中失血量为(31.6±6.8)ml,明显少于开腹组的(68.9±21.5)ml(t=8.552,P<0.001)。开腹组获取总淋巴结(17.6±3.3)枚,明显少于腹腔镜组的(20.6±4.8)枚(t=3.012,P=0.004),但两组患者在阳性淋巴结个数方面差异无统计学意义(t=0.391,P=0.697)。腹腔镜手术可明显改善术后胃肠功能恢复的时间。腹腔镜组和开腹组的术后并发症发生率相近,分别为11.5%和20.0%(X^2=0.812,P=0.367)。腹腔镜组术后3、5年生存率分别为80.2%和57.2%,开腹组分别为75.0%、62.9%,差异无统计学意义(P=0.830)。结论腹腔镜辅助联合CME的右半结肠切除术是一项安全有效的术式,其短期预后优于开腹手术,长期预后与开腹手术相近。
Objective To investigate the feasibility,safety,short- and long- term prognosis oflaparoscopic surgery combined with complete mesocolic excision（CME）for right colon cancer.Methods A retrospective analysis of sixty-six colon cancer patients undergoing radical surgery from January 2008 toMay 2013 was performed.26 cases were treated by laparoscopic surgery（laparoscopic group）and 40 casesby open surgery（open group）.The differences of clinical pathology and survival data were comparedbetween the two groups.Results There were no significant differences between the two groups in thedemographic and clinicopathological data.In laparoscopic group,the amount of blood loss was significantlyless than the open group [（31.6±6.8）ml vs（68.9±21.5）ml,t=8.552,P0.001].In open group,（17.6±3.3）medals of lymph node were harvested,significantly less than the laparoscopic group [（20.6±4.8）medals,t=3.012,P=0.004],but there was no statistical significance in the two groups in the number of positivelymph node（t=0.391,P=0.697）.Laparoscopic surgery could significantly improve the recovery ofgastrointestinal function.Incidence of postoperative complication in laparoscopic group and open groupwas simi（11.5% vs 20.0%,χ~2=0.812,P=0.367）.The cumulative overall survival rate at 3- and 5-year inthe laparoscopic group was 80.2% and 57.2%,with no significant difference compared to 75.0% and 62.9%in the open group（P=0.830）.Conclusions Laparoscopic assisted right- hemicolectomy with CME forcolon carcinoma is safe and effective.Compared to open operation,it has better short-term and similarlong-term prognosis.
出处
《中华普通外科学文献（电子版）》
2016年第6期424-427,共4页
Chinese Archives of General Surgery(Electronic Edition)
基金
揭阳市科技计划资助项目(20130304)
关键词
结肠肿瘤
结肠系膜
腹腔镜
剖腹术
Colonic neoplasms
Mesocolon
Laparoscopes
Laparotomy
