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目的评估腹腔镜治疗结直肠癌的短期疗效,探讨腹腔镜治疗结直肠癌的可行性、安全性、有效性。方法自2004年1月至2009年3月,共有35名患者在我院接受了腹腔镜下结直肠癌手术,其中32例为根治性切除术(腹腔镜组),1例为探查术,2例中转开腹。随机选取同期相同数量的开腹手术患者作为开放组。回顾性统计、比较两组的短期疗效,包括手术时间、术中出血量、术中输血量、切口长度、组织病理学数据、术后并发症及术后功能恢复情况。结果腹腔镜组与开放组各为32例,其余3例(1例腹腔镜下探查术,2例中转开腹)独立分析。两组患者的性别、年龄、肿瘤位置及TNM分期无统计学差异。在组织病理学方面,两组无统计学差异(肿瘤切缘:5 cmvs5 cm,P=0.664;清扫淋巴结数量:7vs8,P=0.228)。腹腔镜组与开放组在手术时间(250 minvs180 min,P=0.006)、切口长度(10 cmvs20 cm,P<0.001)、术中输血需要(1例vs10例,P=0.003)、止痛剂使用量(12例vs25例,P=0.004)、术后住院天数(9.5 dvs11 d,P=0.008)、术后肠道功能恢复情况等方面具有统计学差异;在术中出血量(200 mLvs200 mL,P=0.098)、术后并发症发生率(8例vs6例,P=0.545)及术后引流量(507.5 mLvs669.0 mL,P=0.475)等方面无统计学差异。结论尽管病例数量有限,本回顾性分析显示,在肿瘤学安全性和短期疗效方面,腹腔镜下结直肠癌手术不亚于传统开腹手术。
Objective To assess the short-term efficacy of laparoscopy in the treatment of colorectal cancer and to explore the feasibility, safety and effectiveness of laparoscopy in the treatment of colorectal cancer. METHODS: From January 2004 to March 2009, a total of 35 patients underwent laparoscopic colorectal cancer surgery in our hospital, 32 of whom underwent radical resection (laparoscopic group), one of whom underwent exploration and 2 Cases of conversion to open. Randomly select the same number of concurrent open surgery patients as an open group. The retrospective statistics were used to compare the short-term effects of the two groups, including operation time, intraoperative blood loss, intraoperative blood transfusion, incision length, histopathological data, postoperative complications and postoperative functional recovery. Results In the laparoscopic group and the open group, 32 cases each were performed, and the remaining 3 cases (1 laparoscopic exploration and 2 cases converted to laparotomy) were independently analyzed. There was no significant difference in gender, age, tumor location and TNM stage between the two groups. In histopathology, there was no significant difference between the two groups (tumor margin: 5 cm vs 5 cm, P = 0.664; number of lymph nodes dissected: 7 vs 8, P = 0.228). The time of operation (250 min vs 180 min, P = 0.006), the length of incision (10 cm vs 20 cm, P <0.001) and the need for intraoperative blood transfusion (1 vs 10, P = 0.003) (12 vs 25, P = 0.004), postoperative hospital stay (9.5 d vs 11 d, P = 0.008), postoperative recovery of intestinal function and other aspects were statistically significant; the intraoperative blood loss (200 mL vs 200 mL, P = 0.098). The incidence of postoperative complications (8 vs 6, P = 0.545) and postoperative drainage (507.5 mL vs 669.0 mL, P = 0.475) had no significant difference. Conclusions Despite this limited number of cases, this retrospective analysis shows that laparoscopic colorectal cancer surgery is as good as traditional laparotomy in oncology safety and short-term efficacy.