摘要
目的评估腹腔镜手术与开腹手术治疗大肠癌合并肠梗阻的疗效和生存差异。方法将86例大肠癌合并肠梗阻患者随机分为腹腔镜手术组和开腹手术组,每组43例,开腹手术组患者给予开腹手术治疗,腹腔镜手术组患者给予腹腔镜手术治疗,比较两组患者的疗效、围手术期指标(术中出血量、手术时间、术后禁食时间、术后肠道功能恢复时间及住院时间)、术后并发症的发生情况、术后随访1年的生存率及复发率。结果腹腔镜手术组患者疗效优于开腹手术组,差异有统计学意义(P﹤0.05);腹腔镜手术组患者总有效率为100%(43/43),高于开腹手术组的83.72%(36/43),差异有统计学意义(P﹤0.05)。腹腔镜手术组患者术中出血量明显少于开腹手术组,术后禁食时间、术后肠道功能恢复时间、住院时间均明显短于开腹手术组,差异均有统计学意义(P﹤0.01)。腹腔镜手术组患者术后并发症总发生率为2.33%(1/43),低于开腹手术组的13.95%(6/43),差异有统计学意义(P﹤0.05)。术后随访1年,两组患者术后复发率和生存率比较,差异均无统计学意义(P﹥0.05)。结论与开腹手术治疗相比,腹腔镜手术治疗大肠癌合并肠梗阻的疗效更佳,出血少、恢复快、并发症少,值得临床推广应用。
Objective To evaluate the efficacy of laparoscopic surgery and laparotomy in the treatment of colorectal cancer combined with intestinal obstruction and to evaluate the differences of survival. Method This study included 86 patients with colorectal cancer combined with intestinal obstruction who were randomly allocated as laparoscopic surgery group and laparotomy group, including 43 cases in each, respectively. The patients in laparotomy group were treated with conventional open surgery, while those in the laparoscopic surgery group were administered with laparoscopic surgery. The clinical efficacy, perioperative indicators (intraoperative blood loss, operative time, postoperative fasting time, postoperative recovery time of intestinal function and length of hospital stay), occurrence of postoperative complications, survival rate and recurrence rate during 1-year follow-up period were compared between the two groups. Result The efficacy of laparoscopic surgery group was better than laparotomy group, the difference was statistically significant (P<0.05), and the overall response rate in the laparoscopic surgery group was 100%(43/43), which was higher than that of the laparotomy group at 83.72%(36/43), indicating statistical significance (P<0.05). The volume of intraoperative blood loss in laparoscopic surgery group was significantly less than that in laparotomy group, postoperative fasting time, postoperative recovery time of intestinal function and length of hospital stay were shorter than that in laparotomy group, and the difference were statistically significant (P<0.01). The incidence of postoperative complications in laparoscopic surgery group was 2.33%(1/43), and was lower compared to laparotomy group at 13.95%(6/43), showing statistical significance (P< 0.05). During 1-year follow-up, no evident differences were noted in respect to the postoperative recurrence rate and survival rate between the two groups (P>0.05). Conclusion Laparoscopic surgery for colorectal cancer combined with intestinal obstruction is superior to laparotomy in regard of efficacy, with less blood loss, faster recovery, fewer complications, thus it is worthy of clinical application.
作者
施章时
周五一
伍亮
王龙颖
SHI Zhangshi;ZHOU Wuyi;WU Liang;WANG Longying(Department of General Surgery, Air Force Hospital of Southern Theater of PLA, Guangzhou 510602, Guangdong, China)
出处
《癌症进展》
2019年第12期1423-1425,共3页
Oncology Progress
关键词
大肠癌
肠梗阻
腹腔镜手术
开腹手术
colorectal cancer
intestinal obstruction
laparoscopic surgery
laparotomy
