腹腔镜下结肠癌切除术应用于高危结肠癌患者治疗价值.docVIP

腹腔镜下结肠癌切除术应用于高危结肠癌患者治疗价值 　　[摘要] 目的 探讨腹腔镜结肠切除术应用于高危结肠癌患者治疗的临床价值。 方法 60例高危结肠癌患者按手术方法分为两组，LCR组30例行腹腔镜下结肠癌切除术，对照组30例行开放结肠切除术。观察两组手术情况、围手术期并发症、淋巴结清扫数量、复发率。 结果 LCR组平均手术时间与OCR组比较差异均无统计学意义（P0.05），LCR组术中出血量、住院时间、肛门排气时间、术后前3d引流量、引流管拔除时间明显少于OCR组（P0.05）。 结论 腹腔镜下结肠癌切除术治疗高危结肠癌安全有效，符合肿瘤根治原则。 　　[关键词] 腹腔镜；结肠癌切除术；高危结肠癌 　　[中图分类号] R735.35 [文献标识码] B [文章编号] 2095-0616（2015）14-119-04 　　Clinical value of laparoscopic colectomy in the treatment of colonic cancer in high-risk patients 　　CHEN Zhuolin GONG Shiwen WANG Jinlin 　　Department of General Surgery，the Peoples Hospital of Dongguan， Dongguan 523059，China 　　[Abstract] Objective To explore the clinical effect of laparoscopic colectomy in the treatment of colonic cancer in high-risk patients. Methods 60 cases of patients with colonic cancer were divided into two groups.The LCR group（n=30） was managed laparoscopic colectomy and the OCR group（n=30） were traditional open operation.The operation condition，preoperative complications，amount of lymph node scavenged，and the relapse rate of the 2 groups were contrasted. Results The operation period of LCR group with no difference compared to OCR group（P0.05），And the hospital stays，period of passage of gas by anus，the drainage volume post 3 days of operation，the period of drainage tube extraction and the intraoperative bleeding volume of LCR group was significant less than that of OCR group （P0.05）. Conclusion Laparoscopic colectomy can be successfully performed for high-risk colonic cancer，with all the advantages of minimally surgery. 　　[Key words] Laparoscopy；Resection of colonic cancer；Colonic cancer in high-risk 　　我国是消化道肿瘤高发国家，其中结肠癌临床较为常见。据卫生部肿瘤传报注册项目公布数据显示，近30年来我国结肠癌发病率不断上升，2009年粗发病率达到29.44/10万人口，死亡率14.23/10万人口，发病数和死亡数在全部恶性肿瘤中分别列于第三位、第五位[1]。目前结肠癌发病机制尚不明确，手术治疗依然是其治疗的首选方案，且手术的根治程度对于结肠癌的预后具有极其重要的影响。随着腹腔镜等手术器械的更新应用与操作技术上的日趋完美，腹腔镜结肠癌切除术（laparoscopic colorectal resection，LCR）切口疼痛轻、失血量少、术后恢复快等优点日益得到医师和患者的认可，国内外文献均有报道[2-3]。但LCR与传统开腹手术（open colorectal resection，OCR）治疗合并高危因素如肥胖、高龄及其他系统合并症的结肠癌患者是