腹腔镜手术对比开腹手术在结直肠癌根治术中的安全性分析
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摘要
目的探析腹腔镜手术对比开腹手术在结直肠癌根治术中的安全性。方法随机选取2011年1月～2017年8月我院收治的结直肠癌患者共50例,采用简单随机数字表法将其分为观察组和对照组,每组各25例,观察组采用腹腔镜手术,对照组采用开腹手术。分别观察两组患者术中指标、术后情况、并发症出现情况、不同时间段生存率。结果观察组手术所需时间、术中出血量、切口长度、保肛均优于对照组[(123.62±32.62)min vs (98.34±15.64)min;(92.37±5.37)mL vs (128.34±29.74)mL;(5.98±1.25)cm vs(19.47±2.33)cm;92.00%vs 64.00%];观察组住院所需时间、肛门排气时间、进食所需时间、下床活动所需时间、VAS评分均少于对照组[(6.32±1.25)d <(13.67±1.57)d;(2.28±0.32)d <(4.21±0.87)d;(4.65±1.85)d<(7.98±1.23)d;(1.52±1.22)d <(4.62±1.85)d;(4.66±1.28)分<(8.64±1.03)分)];并发症总出现率低于对照组(8.00%<32.00%);观察组治疗后9个月、12个月生存率高于对照组(P <0.05)。结论与开腹手术相比,给予结直肠癌患者采用腹腔镜手术不仅能够改善术后各项指标,更利于保证患者术中的生命安全,该治疗模式具有独特的临床优势,值得临床推广应用。
Objective To evaluate the safety of laparoscopic surgery versus open surgery in radical resection for colorectal cancer. Methods 50 patients with colorectal cancer who were admitted and treated in our hospital from January 2011 to August 2017 were randomly selected. According to simple random number table method,they were divided into the observation group and the control group,with 25 cases in each group.The observation group was given laparoscopic surgery while the control group was given open surgery.Intraoperative indexes,postoperative conditions,complications and survival rates at different time periods were respectively observed in the two groups. Results The operation time,intraoperative bleeding volume,length of incision and anus preservation of the observation group were all better than those of the control group [(123.62±32.62)min vs(98.34±15.64)min;(92.37±5.37)mL vs(128.34±29.74)mL;(5.98±1.25)cm vs(19.47±2.33)cm;92.00% vs 64.00%].The hospital stay,anal exhaust time,feeding time,time required for out of bed activity and VAS score of the observation group were all less than those of the control group [(6.32±1.25)d <(13.67±1.57)d;(2.28±0.32)d <(4.21±0.87)d;(4.65±1.85)d <(7.98±1.23)d;(1.52±1.22)d <(4.62±1.85)d;(4.66±1.28)points<(8.64±1.03)points].The total incidence of complications of the observation group was lower than that of the control group(8.00% < 32.00%).After treatment for 9 months and 12 month,the survival rate of the observation group was higher than that of the control group(P < 0.05). Conclusion Compared with open surgery,laparoscopic surgery for patients with colorectal cancer can not only improve the postoperative indexes,but also ensure the life safety of patients.This treatment mode has unique clinical advantages and is worthy of clinical application.
Objective To evaluate the safety of laparoscopic surgery versus open surgery in radical resection for colorectal cancer. Methods 50 patients with colorectal cancer who were admitted and treated in our hospital from January 2011 to August 2017 were randomly selected. According to simple random number table method,they were divided into the observation group and the control group,with 25 cases in each group.The observation group was given laparoscopic surgery while the control group was given open surgery.Intraoperative indexes,postoperative conditions,complications and survival rates at different time periods were respectively observed in the two groups. Results The operation time,intraoperative bleeding volume,length of incision and anus preservation of the observation group were all better than those of the control group [(123.62±32.62)min vs(98.34±15.64)min;(92.37±5.37)mL vs(128.34±29.74)mL;(5.98±1.25)cm vs(19.47±2.33)cm;92.00% vs 64.00%].The hospital stay,anal exhaust time,feeding time,time required for out of bed activity and VAS score of the observation group were all less than those of the control group [(6.32±1.25)d <(13.67±1.57)d;(2.28±0.32)d <(4.21±0.87)d;(4.65±1.85)d <(7.98±1.23)d;(1.52±1.22)d <(4.62±1.85)d;(4.66±1.28)points<(8.64±1.03)points].The total incidence of complications of the observation group was lower than that of the control group(8.00% < 32.00%).After treatment for 9 months and 12 month,the survival rate of the observation group was higher than that of the control group(P < 0.05). Conclusion Compared with open surgery,laparoscopic surgery for patients with colorectal cancer can not only improve the postoperative indexes,but also ensure the life safety of patients.This treatment mode has unique clinical advantages and is worthy of clinical application.
引文
[1]熊小勇,徐降兴,习举云.腹腔镜手术对比开腹手术在结直肠癌根治术中的安全性及远期疗效评估[J].实用癌症杂志,2016,31(10):1665-1668.
[2]谢军,张文利.腹腔镜与开腹手术在老年结直肠癌治疗中的疗效及安全性分析[J].实用癌症杂志,2016,31(11):1845-1847.
[3]丁海涛,韩智君,曹杰,等.腹腔镜与传统开腹乙状结肠癌根治术临床疗效对比及安全性分析[J].现代中西医结合杂志,2016,25(35):3923-3926.
[4]袁建华.腹腔镜与开放手术治疗直肠癌的远期效果比较研究[J].中外医学研究,2018,16(6):46-47.
[5]郭玉霖,杨培,徐晓,等.腹腔镜下同期结直肠癌和肝转移灶切除术的安全性和疗效分析[J].解放军医学院学报,2017,38(1):26-29.
[6]张蔚翔.结直肠癌实施腹腔镜根治术辅以术中热灌注化疗的效果评价[J].现代中西医结合杂志,2016,25(27):3030-3032.
[7]郑小平,贺旭东,范月秀,等.腹腔镜和开腹手术治疗结直肠癌的临床效果比较[J].中国当代医药,2017,24(20):68-70.
[8]戚文元,戎吉龙.腹腔镜与开腹直肠癌根治术对患者远期预后的影响及相关因素分析[J].中国中西医结合外科杂志,2017,23(1):84-86.
[9]刘航,张跃天,刘震,等.腹腔镜结直肠癌手术与开放性手术的疗效及安全性分析[J].实用癌症杂志,2017,32(3):418-420.
[10]陈策,王荣寅,丁德胜.对比常规开腹手术和腹腔镜下直肠癌手术的近期疗效及安全性分析[J].中华全科医学,2017,15(9):1515-1517.
[11]何利,何茂梁,袁波,等.腹腔镜手术治疗对结直肠癌患者血清炎性因子、VEGF、MMP9、氧化应激及免疫功能的影响[J].海南医学院学报,2017,23(18):2546-2549.
[12]杨占祥,张文革,张晓飞,等.腹腔镜直肠癌切除术与开腹根治术的远期疗效对比[J].现代生物医学进展,2016,16(30):5923-5925.
[13]侯召民.腹腔镜手术与开腹手术对直肠癌的疗效和安全性比较[J].河北医药,2016,38(23):3564-3568.
[14]沈雄飞,江礼娟,马冬华,等.结直肠癌根治术后淋巴结检出数目的影响因素分析[J].中华消化外科杂志,2017,16(7):731-735.
[15]柯昌松,向波,王斌,等.腹腔镜手术和传统开腹TME手术在直肠癌患者中的疗效对比观察[J].现代消化及介入诊疗,2016,21(6):880-882.
[16]郭贇卿.两种腹腔镜直肠癌根治术的术中护理比较研究[J].检验医学与临床,2016,13(1):171-172.
[17]蔡巧英,徐江南,李丽军,等.腹腔镜与开腹结直肠癌根治术后粘连性肠梗阻发生情况比较[J].浙江医学,2017,39(18):1588-1589.
[2]谢军,张文利.腹腔镜与开腹手术在老年结直肠癌治疗中的疗效及安全性分析[J].实用癌症杂志,2016,31(11):1845-1847.
[3]丁海涛,韩智君,曹杰,等.腹腔镜与传统开腹乙状结肠癌根治术临床疗效对比及安全性分析[J].现代中西医结合杂志,2016,25(35):3923-3926.
[4]袁建华.腹腔镜与开放手术治疗直肠癌的远期效果比较研究[J].中外医学研究,2018,16(6):46-47.
[5]郭玉霖,杨培,徐晓,等.腹腔镜下同期结直肠癌和肝转移灶切除术的安全性和疗效分析[J].解放军医学院学报,2017,38(1):26-29.
[6]张蔚翔.结直肠癌实施腹腔镜根治术辅以术中热灌注化疗的效果评价[J].现代中西医结合杂志,2016,25(27):3030-3032.
[7]郑小平,贺旭东,范月秀,等.腹腔镜和开腹手术治疗结直肠癌的临床效果比较[J].中国当代医药,2017,24(20):68-70.
[8]戚文元,戎吉龙.腹腔镜与开腹直肠癌根治术对患者远期预后的影响及相关因素分析[J].中国中西医结合外科杂志,2017,23(1):84-86.
[9]刘航,张跃天,刘震,等.腹腔镜结直肠癌手术与开放性手术的疗效及安全性分析[J].实用癌症杂志,2017,32(3):418-420.
[10]陈策,王荣寅,丁德胜.对比常规开腹手术和腹腔镜下直肠癌手术的近期疗效及安全性分析[J].中华全科医学,2017,15(9):1515-1517.
[11]何利,何茂梁,袁波,等.腹腔镜手术治疗对结直肠癌患者血清炎性因子、VEGF、MMP9、氧化应激及免疫功能的影响[J].海南医学院学报,2017,23(18):2546-2549.
[12]杨占祥,张文革,张晓飞,等.腹腔镜直肠癌切除术与开腹根治术的远期疗效对比[J].现代生物医学进展,2016,16(30):5923-5925.
[13]侯召民.腹腔镜手术与开腹手术对直肠癌的疗效和安全性比较[J].河北医药,2016,38(23):3564-3568.
[14]沈雄飞,江礼娟,马冬华,等.结直肠癌根治术后淋巴结检出数目的影响因素分析[J].中华消化外科杂志,2017,16(7):731-735.
[15]柯昌松,向波,王斌,等.腹腔镜手术和传统开腹TME手术在直肠癌患者中的疗效对比观察[J].现代消化及介入诊疗,2016,21(6):880-882.
[16]郭贇卿.两种腹腔镜直肠癌根治术的术中护理比较研究[J].检验医学与临床,2016,13(1):171-172.
[17]蔡巧英,徐江南,李丽军,等.腹腔镜与开腹结直肠癌根治术后粘连性肠梗阻发生情况比较[J].浙江医学,2017,39(18):1588-1589.