摘要
目的比较手辅助腹腔镜手术(HALS)和腹腔镜辅助手术(LAS)以及开腹手术(OS)在结直肠癌中的近期临床疗效。方法回顾性分析2011年10月至2015年12月我科由同一组医师采用3种术式完成治疗的74例结直肠癌患者的临床资料,比较3组患者的术后近期临床疗效,包括术中指标、术后恢复情况、术后并发症、肿瘤根治性和住院费用。结果最终纳入HALS组24例患者,LAS组和OS组各25例患者,3组患者的一般资料和肿瘤基线具有可比性。对比结果显示,OS组、HALS组和LAS组的手术时间依次增加,切口长度依次缩短(P<0.05);HALS组的戳卡数少于LAS组(P<0.05),2组的中转率无统计学差异(P>0.05)。在术后恢复、术后并发症发生率和肿瘤根治性方面,3组无统计学差异(P>0.05)。在住院费用方面,HALS组和LAS组的总费用和手术费高于OS组(P<0.05),而HALS组和LAS组之间无统计学差异(P>0.05);对于材料费,OS组、HALS组和LAS组依次增加(P<0.05);其他费用明细3组之间无统计学差异(P>0.05)。结论 3种术式各具优势,既相互独立又能互相补充,临床医师可根据个人掌握程度和患者情况选择合理术式。
Objective To compare the short-term chnical outcomes of hand-assisted laparoscopic surgery （HAl,S）, laparoscopic-assisted surgery （LAS） and open surgery （OS） for colorectal cancer treatment. Methods The clinical data of 74 patients underwent HALS, LAS and OS for colorectal cancer treatment between October 2011 and December 2015 were assessed retrospectively. All the surgeries were performed by the stone surgical team. The intraoperative details, postoperative recovery, postoperative complications, oncologic results and cost were compared among the three groups. Results A total of 24 patients in HALS group, 25 patients in LAS group and 25 patients in OS group were finally included. The general data and oncologic baseline were comparable among the three groups. The comparative results showed that the operative time increased and incision length shortened gradually in OS group, HALS group and LAS group （P 〈 0.05）. HALS group was favor of less number of trocars used compared with LAS group （P 〈 0.05 ）, but there was no statistical difference of the conversion rate between the two groups （ P 〉 0.05 ）. In terms of postoperative recovery, postoperative complications and oncologic results, there was no statistical difference between the three groups （P 〉 0.05 ）. As for cost, the total cost and operative cost of OS group were lower than HALS group and LAS group （P 〈 0.05 ）, but there was no significant difference between HALS group and LAS group （P 〉 0.05 ）. The material cost increase gradually in OS group, HALS group and LAS group （ P 〈 0.05 ）, and there was no significant difference on the part of other cost among the three groups （P 〉 0.05 ）. Conclusion HALS, LAS and OS are compensatory with each other, and clinicians can choose the reasonable procedure according to personal proficiency and situation of patients.
出处
《中国医科大学学报》
CAS
CSCD
北大核心
2017年第2期126-130,135,共6页
Journal of China Medical University
基金
沈阳市科技局社发基金(F14-158-9-35)
关键词
手辅助腹腔手术
腹腔镜辅助手术
开腹手术
结直肠癌
hand-assisted laparoscopic surgery
laparoscopic-assisted surgery
open surgery
colorectal cancer
