摘要
目的探讨终末期肾病并发结肠癌患者腹腔镜手术治疗的疗效及安全性。方法回顾性分析2014年1月至2019年5月天津市第一中心医院共31例终末期肾病并发结肠癌患者(持续性血液透析)行腹腔镜辅助结肠癌根治术的临床资料(观察组),并选取同期结肠癌患者(无肾功能障碍)35例作为对照组,比较两组患者围手术期资料及随访结果。结果观察组患者手术时间更长[(187±20)min比(174±21)min,t=2.381,P=0.020],术中失血量[90(80~110)ml比50(40~60)ml,Z=-6.580,P<0.001]和术后引流量[(417±89)ml比(208±67)ml,t=10.858,P<0.001]更多,术后住院时间[(13.68±2.10)d比(9.09±1.65)d,t=9.918,P<0.001]和住院总费用[9.2(8.8~9.6)万元比6.1(5.8~6.5)万元,Z=-6.976,P<0.001]增加。两组患者淋巴结清扫数目和术后第1次排气时间差异均无统计学意义(均P>0.05)。观察组和对照组患者手术并发症发生率分别为23%和9%,差异无统计学意义(P=0.170)。61例(92%)患者完成随访,中位随访时间为6(2~12)个月,观察组和对照组各发现1例肝转移患者。结论终末期肾病并发结肠癌患者行腹腔镜辅助结肠癌根治术是安全有效的。
Objective To explore the efficacy and safety of laparoscopic colon cancer surgery for patients with end-stage renal disease.Methods Thirty-one end-stage renal disease patients(continuous hemodialysis)underwent laparoscopic colon cancer surgery from Jan 2014 to May 2019 in Tianjin First Central Hospital compared to 35 colon cancer patients with normal renal function.Result Compared with the control group,the operation time in laparoscopic group was longer[(187±20)min vs.(174±21)min,t=2.381,P=0.020],the intraoperative blood loss was more[90(80-110)ml vs.50(40-60)ml,Z=-6.580,P<0.001],the postoperative drainage volume was more[(417±89)ml vs.(208±67)ml,t=10.858,P<0.001],the postoperative hospitalization time was longer[(13.68±2.10)d vs.(9.09±1.65)d,t=9.918.P<0.001],and the total hospitalization costs were higher[9.2(8.8-9.6)ten thousand yuan vs.6.1(5.8-6.5)ten thousand yuan,Z=-6.976,P<0.001].There was no significant difference in overall morbidity between the two group(23%vs.9%,P=0.170).Sixty-one patients(92%)were followed up for a median time of 6 months.One case of liver metastasis was found in each group.Conclusion Laparoscopic colon cancer surgery can be a safe and effective procedure in patients with end-stage renal disease.
作者
山院飞
王翀
王伟强
谭志军
Shan Yuanfei;Wang Chong;Wang Weiqiang;Tan Zhijun(Department of General Surgery,Tianjin First Central Hospital,Tianjin 300192,China)
出处
《中华普通外科杂志》
CSCD
北大核心
2021年第10期762-765,共4页
Chinese Journal of General Surgery
关键词
结肠肿瘤
肾功能衰竭
慢性
腹腔镜
安全
Colonic neoplasms
Kidney failure,chronic
Laparoscopy
Safety
