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目的对比腹腔镜辅助下结直肠癌手术与开放手术的远期疗效。方法将结直肠癌患者80例根据手术方法分为腹腔镜组与开放手术组各40例。通过记录并对比2组术中出血量、手术时间、住院时间以及淋巴结清扫数量,并在术后对所有患者进行为期18~56个月的随访,统计患者的生存状况及远处转移率、局部复发率及并发症发生情况和病死率。结果腹腔镜组术中出血量少于开放手术组,住院时间短于开放手术组,差异均有统计学意义(P<0.05)。而2组手术时间及淋巴结清扫数量比较差异无统计学意义(P>0.05)。2组局部复发率、远处转移率比较差异无统计学意义(P>0.05)。腹腔镜组术后并发症发生率为7.5%低于开放手术组的20.0%,差异有统计学意义(P<0.05)。对所有患者进行为期18~56个月的随访,平均随访时间为(33.6±2.45)个月,其中腹腔镜组病死率为15.0%(6/40),开放手术组病死率为20.0%(8/40),2组病死率比较差异无统计学意义(P>0.05)。结论腹腔镜手术治疗结直肠癌,其远期疗效和开放手术相比,无明显差异,但该治疗方法更为安全有效,且术中出血量相对较少,利于患者术后恢复,因此值得进一步推广应用。
Objective To compare the long-term efficacy of laparoscopic-assisted colorectal surgery and open surgery. Methods 80 patients with colorectal cancer were divided into laparoscopic group and open surgery group according to the surgical method in 40 cases. By recording and comparing the amount of blood loss, operation time, hospitalization time and lymph node dissection in two groups, all patients were followed up for 18-56 months after operation, the survival status and distant metastasis rate were calculated, and the local Recurrence rate and complications and mortality. Results The amount of bleeding in laparoscopic group was less than that in open group, and the length of stay in hospital was shorter than that in open group. The difference was statistically significant (P <0.05). There was no significant difference in the number of operation time and lymph node dissection between the two groups (P> 0.05). There was no significant difference in the local recurrence rate and distant metastasis between the two groups (P> 0.05). The incidence of postoperative complications in laparoscopic group was 7.5% lower than that in open surgery group (20.0%, P <0.05). All patients were followed up for 18-56 months. The mean follow-up time was (33.6 ± 2.45) months. The mortality rate in laparoscopic group was 15.0% (6/40) and in open surgery group was 20.0% (8% / 40). There was no significant difference in mortality between the two groups (P> 0.05). Conclusion Laparoscopic surgery for colorectal cancer, long-term efficacy and open surgery compared to no significant difference, but the treatment is more safe and effective, and the amount of bleeding during surgery is relatively small, conducive to postoperative recovery, so it is worth further Promote the application.