腹腔镜结直肠癌根治术的疗效对比研究.docVIP

腹腔镜结直肠癌根治术的疗效对比研究 郧阳医学院附属太和医院普外科(442000) 狄茂军 陶凯雄　刘焱伟 屈振繁 黄东 兰明银 孙勤 【摘要】　目的　探讨我院在引进腹腔镜结直肠癌根治术后在学习曲线期间治疗直肠癌的临床效果。 方法　前瞻性分析2005年1月至2007年6月行腹腔镜结直肠癌手术的20例临床资料,并与同期的20例开腹手术在临床和病理解剖学参数方面进行比较。结果　比较了两组间年龄、性别肿瘤大小与TNM分期。与开腹手术比,手术时间无差别，术中出血量较少(p0.0001),腔镜组手术时间略长[(148. 0±65. 0)Vs(139. 0±37. 4)min,P=0. 000],术后肠功能恢复快、进食早(p0.0001),术后住院天数短(p0.0001),术中并发症 (10% LSG vs 15% CSG)和总体并发症(35% LSG vs 45% CSG)并无差别。 　结论　腹腔镜结直肠癌根治术在学习曲线期间已成为一项有效可靠的技术。　 【关键词】　腹腔镜；结直肠癌 A comparative clinical study of short-term　results of laparoscopic surgery for colorectal　cancer.　 Di Maojun,Tao Kaixiong, Liu Yan-wei,Qu Zhengfan, Huang Dong, Lan Mingyin, Shen Qing. Department of General Surgery, Taihe Hospital,Yunyang Medical College, Shiyan 442000. Abstract　Objective The aim of this study was to assess the results of laparoscopic surgery for colorectal carcinoma during the learning curve throughout the introduction of this technique at our hospital. Methods From January 2005 to June 2007, 40 patients undergoing surgery were assigned to laparoscopic surgery group (LSG) (n=20) or conventional surgery group (CSG) (n=20). Data were prospectively collected to statistically analyze clinical and anatomopathological variables. Results 　 Groups were comparable in age, sex,tumor size and TNM stage. There was no difference in operative time. LSG blood loss was lower (p.0001). LSG peristalsis and oral intake began earlier (p0.0001). LSG hospital stay was shorter (p0.0001). Intraoperative complications (10% LSG vs 15% CSG) and overall morbidity (35% LSG vs 45% CSG) were no different. LSG did not record any anastomotic leakages. Two patients (10%) were converted to open surgery. Conclusion　 LSRC has　been a reliable and efficient technique during the learning curve at our hospital. Keywords　 Laparoscopy；Colorectal cancer 腹腔镜直肠癌根治术分离范围涉及腹腔和盆腔的各象限,血管根部淋巴清扫需特殊器械进行腔内高位结扎血管,技术要求高;手术费用较传统开腹手术高。然而,随着技术的成熟、医生经验的积累以及新型手术器械的不断进步,腹腔镜结直肠手术已得到开展与普及。我们科自2005年引入腹腔镜治疗结直肠癌后，现已行了46例，为了评价在学习曲线期间腹腔镜治疗结直肠癌的疗效，我们比较了腹腔镜与常规手术的疗效。 1资料与方法 1.1 临