腹腔镜与开腹结直肠癌根治术后并发症发生率的比较-外科学(普外)专业论文.docxVIP

万方数据 万方数据 目 录 中文摘要………………………………………………………………1 英文摘要………………………………………………………………3 前 言………………………………………………………………5 资料与方法……………………………………………………………6 结 果………………………………………………………………9 讨 论………………………………………………………………16 结 论………………………………………………………………23 参考文献………………………………………………………………24 致 谢………………………………………………………………27 综 述………………………………………………………………28 2 腹腔镜与开腹结直肠癌根治术后并发症发生率的比较 摘 要 目的 探讨腹腔镜与开腹结直肠癌根治术后并发症发生率的差异。 方法 前瞻性、非随机对比 2000 年 1 月至 2011 年 9 月由同一组医师连续实施的 910 例腹腔镜结直肠癌根治术与 434 例开腹结直肠癌根治术，比较两组患者术后 并发症发生率的差异。 结果 腹腔镜组中转开腹 48 例，占 5.3%。腹腔镜手术组与开腹手术组术后总的 并发症发生率分别为 20.3% (185/910)与 25.3% (110/434) (P0.05，χ2=4.316)； 造口亚组中吻合口瘘的发生率分别为 2.1% (3/145)与 2.2% (2/93) (P0.05， χ2=0.002)，吻合口出血的发生率分别为 3.4% (5/145)与 4.3% (4/93) (P0.05， χ2=0.113)，未造口亚组中吻合口瘘的发生率分别为 3.1% (22/699)与 1.0% (3/301) (P0.05，χ2=3.993)，吻合口出血的发生率分别为 1.6% (11/699)与 2.3% (7/301) (P0.05，χ2=0.673)；肠梗 阻的发生率 分别为 3.4% (31/910)与 5.8% (25/434) (P0.05，χ2=4.077)；乳糜 漏的发生率 分别为 5.8% (53/910)与 3.7% (16/434) (P0.05，χ2=2.757)；尿潴留的发生率分别为 1.5% (14/910)与 1.6% (7/434) (P0.05， χ2=0.011)；切口感染的发生率分别为 2.2% (20/910)与 4.6% (20/434) (P0.05， χ2=5.913)；肺部感染的发生率分别为 6.4% (58/910)与 10.6% (46/434) (P0.05， χ2=7.349)。 结论 腹腔镜结直肠癌根治术后总并发症发生率显著低于开腹结直肠癌根治术， 特别是前者术后肠梗阻、切口感染与肺部感染发生率显著低于后者。 关键词 腹腔镜 结直肠肿瘤 根治术 并发症 1 2 Comparison of the Incidence of Postoperative Complications following Laparoscopic and Open Radical Resection for Colorectal Cancer Abstract Objective To compare the postoperative complications following laparoscopic and open radical resection for colorectal cancer. Methods From January 2000 to September 2011, 1344 patients with colorectal cancer were divided into two groups prospectively and nonrandomly, laparoscopic surgery(LP)group (n=910) and open surgery(OP)group (n=434). The postoperative complications were compared between two groups. Results 48 patients (5.3%, 48/910) in laparoscopic group were converted to open operation. Patients in LP group had less blood loss, as compared with those in OP group, and there was no difference in operative time between both groups. The