摘要
目的:探讨腹腔镜辅助结直肠癌根治术的远期疗效及其预后的影响因素。方法:回顾分析2004年1月至2006年12月施行82例腹腔镜结直肠癌手术及86例开放手术的临床资料,统计分析两组患者的一般资料、手术情况、病理结果及生存期等数据。结果:168例中失访21例,随访的147例中目前仍存活101例,死亡46例。开放手术组患者术后1年、3年、5年整体生存率分别为91.7%、67.6%、64.6%;腹腔镜组术后1年、3年、5年整体生存率分别为96.0%、89.3%、63.6%。Log-rank检验显示差异有统计学意义(P=0.049)。单因素分析:与结直肠癌预后有关的因素包括手术方式、分化程度、淋巴结转移、病理分期、术前CEA、术后化疗。按ɑ=0.05标准,进行Cox回归模型多因素分析表明,分化程度、pTNM分期、术前CEA、术后化疗是影响结直肠癌生存的独立预后指标,相对危险度分别为1.522,3.019,2.038,1.762。结论:腹腔镜结直肠癌手术的远期疗效优于开放手术,但不是影响结直肠癌预后的独立因素。分化程度、pTNM分期、术前CEA、术后化疗是影响结直肠癌患者远期生存的独立预后指标,其中肿瘤分期是影响结直肠癌预后最重要的因素。
Objective：To evaluate the prostecdtive efficacy of laparoscopic radical surgery of colorectal carcinoma,and to analyse the multivariate prognostic factors.Methods：All 86 patients who underwent traditional open surgery and 82 patients for laparoscopic resection of colorectal carcinoma from Jan.2004 to Dec.2006 were followed up.The common state of patients,operative information,pathology and life span were statistically analyzed.Results：Among the 168 patients,147 patients were followed up,with 21 cases loss of following up and 101 cases still alive,46 cases died.After the curative resection,the overall probabilities of survival at 1,3,5 years of the laparoscopic and open resection groups were 96.0%,89.3%,63.6% and 91.7%,67.6%,64.6% respectively,P=0.049 by Log-rank test.Univariate analysis showed that operandi modus,histological subtypes,lymph node metastasis,pTNM staging,preoperative CEA and postoperative chemotherapy were correlated with prognosis of colorectal carcinoma.By Cox regression model multivariate analysis（ɑ=0.05）,histological subtypes,pTMN stage,preoperative CEA and postoperative chemotherapy were the independent prognostic factors for colorectal carcinoma patients,relative risk was 1.522,3.019,2.038 and 1.762.Conclusions：The long-time outcome of laparoscopic surgery is better than the traditional surgery,but operandi modus is not an independent prognostic factor.Histological subtypes,pTMN stage,preoperative CEA and postoperative chemotherapy are the independent prognostic factors for long-time survival of colorectal carcinoma patients,among which pTMN stage is the most important.
出处
《腹腔镜外科杂志》
2010年第9期676-680,共5页
Journal of Laparoscopic Surgery
关键词
结直肠肿瘤
腹腔镜检查
预后
因素分析
统计学
对比研究
Colorectal neoplasms
Laparoscopy
Prognosis
Factor analysis
statistical
Comparative study
