腹腔镜与传统开腹结直肠癌根治术手术效果对比
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摘要
目的分析腹腔镜结直肠癌根治术的微创优势。方法选取2015年4月～2017年2月我院收治的80例结直肠癌患者作为研究对象,根据随机数字表法分为对照组和试验组,每组40例。对照组采用开腹结直肠癌根治术治疗,试验组采用腹腔镜结直肠癌根治术治疗,比较两组患者的切口长度、术中出血量、手术时间、肛门排气时间、住院时间以及术后肺部感染、尿路感染、异常出血、吻合口瘘、切口愈合不良并发症发生率。结果试验组切口长度小于对照组[(6.30±1.24)cm vs (14.80±3.80)cm]、术中出血量少于对照组[(68.45±29.65)ml vs (134.68±35.49)ml]、肛门排气时间[(2.89±1.32)d vs (3.82±1.45)d]、住院时间[(11.47±3.04)d vs (18.62±2.67)d]更短,差异具有统计学意义(P<0.05);两组手术时间比较,差异无统计学意义(P>0.05);对照组患者并发症总发生人次高于试验组(19 vs 4),试验组切口愈合不良发生率更低(0/37 vs 7/39),差异有统计学意义(P<0.05)。结论腹腔镜结直肠癌根治术短期疗效确切,具有创伤小,术中出血量少,术后胃肠道功能恢复快,术后并发症少等优势。
Objective To analyze the minimally invasive advantages of laparoscopic radical resection of colorectal cancer.Methods The 80 patients with colorectal cancer admitted to our hospital from April 2015 to February 2017 were enrolled. The patients were divided into the control group and the experimental group according to the random number table method, 40 cases in each group. The control group was treated with radical resection of colorectal cancer. The experimental group was treated with laparoscopic radical resection of colorectal cancer. The incision length, intraoperative blood loss, operation time, anal exhaust time, hospital stay and postoperative time were compared between the two groups. Pulmonary infection, urinary tract infection, abnormal bleeding, anastomotic leakage, and incidence of adverse complications of wound healing. Results The length of the incision in the experimental group was better than that in the control group [(6.30±1.24) cm vs(14.80±3.80) cm], and the intraoperative blood loss was less than that in the control group [(68.45±29.65) ml vs(134.68±35.49) ml], anal row gas time [(2.89±1.32) d vs(3.82±1.45) d], hospitalization time [(11.47±3.04) d vs(18.62±2.67) d] was shorter, the difference was statistically significant(P<0.05). There was no significant difference in the operation time between the two groups(P >0.05). In the control group, the total number of complications was higher than that in the experimental group(19 vs 4). The incidence of incision healing was lower in the experimental group(0/37 vs 7/39),the difference was statistically significant( P <0.05).Conclusion Laparoscopic radical resection of colorectal cancer is effective in short-term, with less trauma, less intraoperative blood loss, faster recovery of gastrointestinal function and less postoperative complications.
Objective To analyze the minimally invasive advantages of laparoscopic radical resection of colorectal cancer.Methods The 80 patients with colorectal cancer admitted to our hospital from April 2015 to February 2017 were enrolled. The patients were divided into the control group and the experimental group according to the random number table method, 40 cases in each group. The control group was treated with radical resection of colorectal cancer. The experimental group was treated with laparoscopic radical resection of colorectal cancer. The incision length, intraoperative blood loss, operation time, anal exhaust time, hospital stay and postoperative time were compared between the two groups. Pulmonary infection, urinary tract infection, abnormal bleeding, anastomotic leakage, and incidence of adverse complications of wound healing. Results The length of the incision in the experimental group was better than that in the control group [(6.30±1.24) cm vs(14.80±3.80) cm], and the intraoperative blood loss was less than that in the control group [(68.45±29.65) ml vs(134.68±35.49) ml], anal row gas time [(2.89±1.32) d vs(3.82±1.45) d], hospitalization time [(11.47±3.04) d vs(18.62±2.67) d] was shorter, the difference was statistically significant(P<0.05). There was no significant difference in the operation time between the two groups(P >0.05). In the control group, the total number of complications was higher than that in the experimental group(19 vs 4). The incidence of incision healing was lower in the experimental group(0/37 vs 7/39),the difference was statistically significant( P <0.05).Conclusion Laparoscopic radical resection of colorectal cancer is effective in short-term, with less trauma, less intraoperative blood loss, faster recovery of gastrointestinal function and less postoperative complications.
引文
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[7]鲍乐锋,姚鑫,金正贤,等.腹腔镜辅助与开腹结直肠癌根治术临床疗效对比分析[J].湖南师范大学学报(医学版),2017,36(6):64-67.
[2]Xiong B,Ma L,Zhang C,et al.Robotic versus laparoscopic total mesorectal excision for rectal cancer:a meta-analysis[J].JSurg Res,2014,188(2):404-414.
[3]王亮,张俊斌,齐鑫,等.腹腔镜结直肠癌根治术与传统根治术的临床效果对比[J].腹腔镜外科杂志,2015,20(10):765-768.
[4]许庆文,徐飞鹏,王妃凤,等.腹腔镜辅助与开腹结直肠癌根治术临床对比研究[J].中华普外科手术学杂志(电子版),2016,10(2):112-115.
[5]Okuda J,Yamamoto M,Tanaka K,et al.Laparoscopic resection of transverse colon cancer at splenic flexure:technical aspects and results[J].Updates in Surgery,2016,68(1):71-75.
[6]周林荣,姚清深,李晓知.结直肠癌患者腹腔镜手术与开放手术安全性和远期疗效的比较[J].中国肿瘤临床与康复,2016,23(8):906-909.
[7]鲍乐锋,姚鑫,金正贤,等.腹腔镜辅助与开腹结直肠癌根治术临床疗效对比分析[J].湖南师范大学学报(医学版),2017,36(6):64-67.