结直肠癌腹腔镜与开腹手术的临床对照研究(1)
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[摘要] 目的 探讨腹腔镜结直肠癌根治手术的临床应用价值。 方法 回顾分析2009年4月～2011年6月腹腔镜结直肠癌根治手术35例的临床资料，并与同期45例开腹结直肠癌手术进行对比。结果 腹腔镜组手术成功34例，中转开腹1例，无手术死亡病例，无术后出血、吻合口漏等并发症，经统计学分析，手术平均时间(160.0±52.1)min与开腹手术时间(176.9±36.7)min相近，术后排气快，住院时间短，术中平均失血量(101.4±39.3)mL，低于开腹手术(191.1±79.3)mL，两组并发症发生率、淋巴结清扫数等无显著性差异。结论 腹腔镜结直肠癌根治手术具有创伤小、术后恢复快、近期及远期疗效好等优点，优于或相当于传统开腹手术。
[关键词] 腹腔镜；结直肠癌；手术
[中图分类号] R735.3+5 [文献标识码] B [文章编号] 1673-9701(2011)36-150-02
Control Study of Laparoscopic and Open Operation on Colorectal Cancer
PAN Xuke ZHANG Congyu JI Chengxiang ZAN Jianbao WANG Dongshu ZHANG Qinghe
Department of General Surgery，Anqing Hospital Affiliated to Anhui Medical University，Anqing 246003，China
[Abstract] Objective To investigate the clinical application value of laparoscopic -assisted colorectal cancer. Methods All of 35 clinical cases with laparoscopic colorectal cancer radical surgery from April 2009 to June 2011 were analysed retrospectively，and the 45 patients with traditional laparotomy were compared. Results All of 34 cases were successful in the peritoneoscope group with no death and no complications，but 1 case opening the abdomen after all. The statistic datas revealed that the mean surgery time of peritoneoscope group was(160.0±52.1)min ,which was similar with the time of traditional laparotomy(176.9±36.7). In addition，there is nonsignificant difference between two groups in complication rates and the numbers of lymph were settled. Conclusion The peritoneoscope colon cancer permanent control surgery builds the advantage that has the small wound，quick recovery and effective outcomes，which is better than or equivalent of traditional laparotomy.
[Key words] Peritoneoscope；Colorectal cancer；Surgery
20世纪90年代初，腹腔镜技术开始应用于结直肠癌手术，经过近二十年的发展取得了很大的进步，至今已成为腹腔镜消化外科最成熟的手术方式之一[1]。我院自2009年4月～2011年6月开展了腹腔镜结直肠癌根治手术35例，与同期开腹手术的45例患者资料作对比，进行总结、分析，现报道如下。
1 资料与方法
1.1 临床资料
本组结直肠癌患者80例。腹腔镜组35例中，男16例，女19例，年龄26～76岁，平均(56.1±10.9)岁；升结肠癌4例，降结肠癌2例，乙状结肠癌5例，中上段直肠癌10例，低位直肠癌14例；病理类型：高分化腺癌10例，中分化腺癌14例，低分化腺癌11例；Dukes分期：A期18例，B期14例，C期2例，D期1例；单个病灶34例，两处病灶者1例。开腹组45例中，男27例，女18例，年龄34～82岁，平均(60.6±10.5)岁；升结肠癌6例，横结肠癌2例，降结肠癌2例，乙状结肠癌8例，中上段直肠癌13例，低位直肠癌14例；病理类型：高分化腺癌12例，中分化腺癌16例，低分化腺癌17例；Dukes分期：A期9例，B期20例，C期12例，D期4例。两组患者在年龄、性别上无显著性差异(P>0.05)，具有可比性。
1.2 手术方法
均采用全身麻醉。腹腔镜组：结肠癌取平卧位，术者位于肿瘤的对侧；直肠癌取截方位 ......
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