摘要
目的探讨结直肠癌患者腹腔镜手术与开放手术的远期疗效及其安全性。方法选取2006年1月至2015年8月广西玉林市红十字会医院150例结直肠癌患者,按照随机数字表法随机分为腹腔镜组和开放组,每组75例。腹腔镜组患者采用腹腔镜手术治疗,开放组患者采用常规开腹手术治疗。比较两组术后并发症、术后无瘤生存率及术后总生存率。结果腹腔镜组术后并发症发生率(12.0%)低于开腹组(34.7%),差异有统计学意义(X2=10.16,P<0.05)。腹腔镜组切口感染、肺部感染、肠瘘、肠梗阻及吻合口出血的发生率明显低于开放组,差异均有统计学意义(均P<0.05)。两组患者下肢静脉血栓发生率差异无统计学意义(P>0.05)。腹腔镜组患者3年和5年无瘤生存率(66.9%和59.8%)高于开放组(65.7%和53.1%),差异均无统计学意义(均P>0.05)。按病理分期进行亚组分析,术后无瘤生存率差异仍无统计学意义(P>0.05)。腹腔镜组患者5年生存率(70.1%)高于开放组(67.3%),差异无统计学意义(P>0.05)。按病理分期进行亚组分析,两组患者术后5年总生存率差异仍无统计学意义(P>0.05)。结果与开腹手术比较,腹腔镜治疗结直肠癌远期疗效好,且安全性较高,值得临床推广应用。
Objective To explore the long-term effect and safety of laparoscopic versus open radical resection for rectal cancer. Methods One hundred and fifty patients with rectal cancer from January1999 to August 2010 who were scheduled to receive radical resection in our hospital were randomly divided into two groups,each 75 cases. The open group were treated with conventional open surgery,while the laparoscopic group were treated by laparoscopic surgery. The postoperative complications,postoperative diseasefree survival rate and overall survival rate were compared between the two groups. Results The postoperative complication rate of the laparoscopic group was lower than the open group（ 12. 0% and 34. 7%）（χ^2=10. 16,P〈0. 05）; The rate of incision infection,pulmonary infection,intestinal fistula,intestinal obstruction and anastomotic bleeding of laparoscopic group was significantly lower than that of the open group,differences were statistically significant（ P〈0. 05）; There was not statistically significant of lower limb venous thrombosis occurrence rate between two groups（ P〉0. 05）. The 3,5 years disease-free survival rate of the laparoscopic group（ 66. 9% and 59. 8%） was higher than that of the open group（ 65. 7% and 53. 1%）（ P〉0. 05）; According to the pathological staging of subgroup analysis,there was still no difference in disease-free survival when stratification for stage（ P〉0. 05）. The 5 year survival rate of laparoscopic group was higher than that of the open group（ 70. 1% and 67. 3%）（ P〉0. 05）. According to the pathological staging of subgroup analysis,there was still no difference in overall 5 years survival rate when stratification for stage（ P〉0. 05）. Conclusion Compared with open surgery,the long-term outcomes of laparoscopic treatment of colorectal cancer are comparable,can reduce postoperative complication. Laparoscopic surgery can be used for radical resection of colorectal cancer.
出处
《中国肿瘤临床与康复》
2016年第8期906-909,共4页
Chinese Journal of Clinical Oncology and Rehabilitation
关键词
腹腔镜
结直肠肿瘤
安全性
Laparoscopy
Colorectal neoplasms
Safety
