腹腔镜与开腹直肠癌手术近期疗效对比

doi:10.3969/j.issn.1006-7795.2013.05.011

首都医科大学学报 ›› 2013, Vol. 34 ›› Issue (5): 689-692.doi: 10.3969/j.issn.1006-7795.2013.05.011

腹腔镜与开腹直肠癌手术近期疗效对比

邱枫, 王今

首都医科大学附属北京友谊医院普外科, 北京 100050

收稿日期:2012-11-07 出版日期:2013-10-21 发布日期:2013-10-22
通讯作者: 王今 E-mail:iamwang_jin@sina.com
基金资助:
北京市优秀人才培养资助项目(2012D003034000011)。

Comparative analysis of short-term outcomes of laparoscopic and open surgery for rectal cancer

QIU Feng, WANG Jin

Department of Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050

Received:2012-11-07 Online:2013-10-21 Published:2013-10-22
Supported by:
This study was supported by Beijing municipal Foundation for the Excellent Talents (2012D003034000011).

摘要/Abstract

摘要：

目的比较腹腔镜与开腹直肠癌手术治疗的近期疗效。方法回顾性分析2009年1月至2012年3月首都医科大学附属北京友谊医院普外科直肠癌手术病例共138例,其中,腹腔镜手术82例,开腹手术56例,对比2组手术的近期疗效,包括手术根治性、术中情况、术后恢复情况及术后合并症等几方面。结果腹腔镜组与开腹组术中出血分别为(103.0±93.1)mL和(158.0±130.1)mL,术后使用镇痛人数分别为18(22.0%)和29(51.8%),术后排气时间分别为(2.4±0.6)d和(2.8±0.9)d,术后排便时间分别为(3.3±1.0)d和(3.7±1.3)d,术后进食时间分别为(3.8±1.3)d和(4.6±2.0)d,住院时间分别为(19.6±7.1)d和(22.0±9.1)d,术后合并症发生率分别为14(17.1%)和21(37.5%),以上各项指标比较,差异均有统计学意义(P<0.05),其余各项指标之间比较,差异无统计学意义。结论腹腔镜直肠癌手术具有同开腹手术相同的根治效果,而且具有住院时间短、术中出血少、术后疼痛轻、胃肠功能恢复快及术后合并症少等优势。

关键词: 直肠癌, 腹腔镜手术, 近期疗效

Abstract:

Objective To conduct a comparative analysis of short-term outcomes of laparoscopic and open surgery for rectal cancer. Methods Retrospective analysis was performed on 138 cases who underwent rectal cancer surgery in Beijing Friendship Hospital from January 2009 to March 2012. The cases were divided into laparoscopic surgery group (n=82) and open surgery group (n=56). The short-term outcomes, including radical therapeutic effect of surgery, intraoperative details, postoperative recovery and postoperative complications were compared between the two groups.Results The blood loss of laparoscopic group and open surgery group were (103.0±93.1)mL and (158.0±130.1)mL. The postoperative analgesia number was 18 (22.0%) and 29 (51.8%), flatus time was (2.4±0.6) days and (2.8±0.9) days, defecation time was (3.3±1.0) days and (3.7±1.3) days, the postoperative feeding time was (3.8±1.3) days and (4.6±2.0) days, hospital stay was (19.6±7.1) days and (22.0±9.1) days, postoperative complication rates were 14 (17.1%) and 21 (37.5%). The differences mentioned above were statistically significant (P<0.05), and there were no significant differences in the rest of the compared indicators. Conclusion The laparoscopic rectal cancer surgery can achieve the similar radical therapeutic effect as the open surgery. Besides that it has the advantages of shorter hospital stay, less blood loss, less postoperative pain, faster recovery of gastrointestinal function and fewer complications.

Key words: rectal cancer, laparoscopic surgery, short-term outcomes

中图分类号:

R605

邱枫, 王今. 腹腔镜与开腹直肠癌手术近期疗效对比[J]. 首都医科大学学报, 2013, 34(5): 689-692.

QIU Feng, WANG Jin. Comparative analysis of short-term outcomes of laparoscopic and open surgery for rectal cancer[J]. Journal of Capital Medical University, 2013, 34(5): 689-692.

参考文献

[1] Jacobs M, Verdeja J C, Goldstein H S. Minimally invasive colon resection (l aparoscopic colectomy) [J]. Surg Laparosc Endosc, 1991,1(3): 144-150.
[2] Xiong B, Ma L, Zhang C. Laparoscopic versus open total mesorectal excision for middle and low rectal cancer: a meta-analysis of results of randomized controlled trials[J]. J Laparoendosc Adv Surg Tech A,2012,22(7): 674-684.
[3] Arezzo A,Passera R,Scozzari G,et al. Laparoscopy for rectal cancer reduces short-term mortality and morbidity: results of a systematic review and meta-analysis[J]. Surg Endosc, 2013,27(5): 1485-1502.
[4] Guillou P J,Quirke P,Thorpe H,et al.Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial[J]. Lancet,2005,365(9472): 1718-1726.
[5] Green B L,Marshall H C,Collinson F,et al.Long-term follow-up of the Medical Research Council CLASICC trial of conventional versus laparoscopically assisted resection in colorectal cancer[J]. Br J Surg,2013,100(1): 75-82.
[6] Park I J,Choi, G S,Lim K H,et al.Multidimensional analysis of the learning curve for laparoscopic resection in rectal cancer[J]. J Gastrointest Surg,2009,13(2): 275-281.
[7] Lujan J,Valero G,Biondo S, et al.Laparoscopic versus open surgery for rectal cancer: results of a prospective multicentre analysis of 4,970 patients[J]. Surg Endosc,2013,27(1): 295-302.
[8] van der Pas M H,Haglind E,Cuesta M A,et al.Laparoscopic versus open surgery for rectal cancer (COLOR Ⅱ): short-term outcomes of a randomised, phase 3 trial[J]. Lancet Oncol,2013,14(3): 210-218.
[9] 胡立军,张正明,胡琦.不同方式腹腔镜直肠癌手术12例分析[J].中国煤炭工业医学杂志,2010,13(5):704.
[10] 宋越.腹腔镜结肠癌根治术的临床评价[J].中华肿瘤防治杂志,2011,18(6):447-449.
[11] 汝敏, 关丽丽,王小燕.腹腔镜下直肠癌根治术术后护理[J].中国煤炭工业医学杂志,2012,15(11):1783-1784.

[1]	李荣雪, 张倩, 邢洁, 孙秀静, 李鹏, 焦月, 张澍田. 超声内镜对早期结直肠癌的诊断价值分析[J]. 首都医科大学学报, 2023, 44(1): 126-130.
[2]	王芸, 李文坤, 苏珈仪, 王亚丹, 吴静. 系统免疫炎症指数在早期结直肠癌及癌前病变筛查中的应用价值[J]. 首都医科大学学报, 2022, 43(5): 760-766.
[3]	司海, 刘然, 熊中原, 曹邦伟. 细胞角蛋白的表达水平与结直肠癌临床病理学特征的相关性研究[J]. 首都医科大学学报, 2022, 43(1): 127-131.
[4]	姚健楠, 高天博, 段凌, 刘健, 蒋玉良, 安广宇, 葛洋. 结直肠癌中O-型糖基化相关差异基因的筛选及分析[J]. 首都医科大学学报, 2020, 41(3): 403-410.
[5]	徐谊, 赵晓牧, 李亚伦, 郭炜, 孙武青, 王今. 128例50岁以下结直肠癌患者的临床特点及预后分析[J]. 首都医科大学学报, 2019, 40(1): 136-142.
[6]	汪栋, 金岚, 姚宏伟, 王今, 赵晓牧, 吴国聪, 杨盈赤, 张忠涛. 35例同时性多原发结直肠癌患者临床诊疗分析[J]. 首都医科大学学报, 2018, 39(3): 413-417.
[7]	杨盈赤, 张忠涛. 液体活检技术在结直肠癌精准医疗中的应用与挑战[J]. 首都医科大学学报, 2017, 38(6): 785-789.
[8]	姚宏伟, 陈宁, 张志鹏, 张忠涛. 完全经肛全直肠系膜切除术联合括约肌间切除治疗超低位直肠癌[J]. 首都医科大学学报, 2017, 38(6): 790-794.
[9]	韩加刚, 王振军, 魏广辉, 高志刚, 杨勇, 翟志伟, 赵宝成. 个体化经肛提肌外腹会阴联合切除术治疗低位进展期直肠癌的探索[J]. 首都医科大学学报, 2017, 38(6): 795-799.
[10]	徐谊, 赵晓牧, 孙武青, 马健, 王岳月, 王今. 直肠癌低位前切除术后吻合口瘘发生相关因素分析[J]. 首都医科大学学报, 2017, 38(5): 727-732.
[11]	田正凤, 陈洪, 翟爱军, 王亚东, 王贵齐, 贺舜. 北京云岗地区体检人群结直肠癌机会性筛查结果分析[J]. 首都医科大学学报, 2016, 37(1): 34-37.
[12]	李艳萍, 李骥, 盖小荣, 吴军, 李文彬, 吴东, 姚方, 李景南. 结直肠息肉发病危险因素分析[J]. 首都医科大学学报, 2013, 34(5): 684-688.
[13]	宋黎明, 邢念增, 牛亦农, 张军晖, 田溪泉, 王建文. 后腹腔镜手术Ⅰ期治疗双侧肾癌2例并文献复习[J]. 首都医科大学学报, 2013, 34(3): 372-375.
[14]	孟倩;赵旭宏;赵瑾;雷婷;张曼. 消化道不同恶性肿瘤患者血清锌α-2-糖蛋白水平检测及临床意义[J]. 首都医科大学学报, 2012, 33(5): 665-668.
[15]	曹广;陶振洲;伍冀湘. 腹腔镜及开腹手术在大肠癌治疗中的临床应用及其对机体免疫功能的影响[J]. 首都医科大学学报, 2012, 33(1): 59-62.

腹腔镜与开腹直肠癌手术近期疗效对比

Comparative analysis of short-term outcomes of laparoscopic and open surgery for rectal cancer

PDF

可视化

被引次数

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价