切换至 "中华医学电子期刊资源库"

中华普通外科学文献(电子版) ›› 2016, Vol. 10 ›› Issue (06) : 428 -430. doi: 10.3877/cma.j.issn.1674-0793.2016.06.011

所属专题: 文献

论著

腹腔镜根治术在结肠单发腺癌治疗中的应用
王鹏利1,()   
  1. 1. 712000 咸阳,陕西中医药大学附属医院普外二科
  • 收稿日期:2016-05-31 出版日期:2016-12-01
  • 通信作者: 王鹏利

Application of laparoscopic radical resection in the treatment of solitary colon adenocarcinoma

Pengli Wang1,()   

  1. 1. The Second Department of General Surgery, Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine, Xianyang 712000, China
  • Received:2016-05-31 Published:2016-12-01
  • Corresponding author: Pengli Wang
  • About author:
    Corresponding author: Wang Pengli, Email:
引用本文:

王鹏利. 腹腔镜根治术在结肠单发腺癌治疗中的应用[J/OL]. 中华普通外科学文献(电子版), 2016, 10(06): 428-430.

Pengli Wang. Application of laparoscopic radical resection in the treatment of solitary colon adenocarcinoma[J/OL]. Chinese Archives of General Surgery(Electronic Edition), 2016, 10(06): 428-430.

目的

对比分析腹腔镜根治术与开腹根治术治疗结肠单发腺癌时,在安全性、术后并发症及临床疗效等方面存在的差异性。

方法

选择2008年4月至2011年4月接受手术治疗的198例结肠单发腺癌患者。采用随机抽样的方法将其分为开腹组和腹腔镜组,每组99例。开腹组患者采取传统的开腹手术,切掉癌变的结肠部分;腹腔镜组患者采取腹腔镜根治术,在腹腔镜的配合下实施癌变结肠部分的切除手术。对两组患者术中和术后的一些相关指标、术后并发症、术后生活质量以及近远期术后的生存率等数据进行统计分析。

结果

腹腔镜组平均手术时间、术中出血量、术后肠功能恢复时间、术后排气时间、住院时间均低于开腹组(t=11.182、22.960、6.420、8.635、16.850,均P<0.01);开腹组术后并发症发生率高于腹腔镜组,差异有统计学意义(17.2% vs 2.0%,χ2=13.100,P=0.000)。腹腔镜组术后5周时的总体生活质量评分优于开腹组(P<0.01)。对于Ⅱ期结肠癌患者,腹腔镜组的术后5年总体生存率要优于开腹组。

结论

患者接受腹腔镜手术来治疗结肠单发腺癌的安全性以及临床疗效均优于开腹手术,且接受腹腔镜手术治疗的患者术后并发症发生率优于开腹手术。

Objective

To compare the safety, postoperative complications and clinical outcomes of patients with single colon adenocarcinoma treated with laparoscopic radical or open radical operation.

Methods

One hundred and ninety-eight colon cancer cases from April 2008 to April 2011 were selected and divided into laparoscopic group and open surgery group randomly, with 99 cases in each group. The open surgery group were treated with traditional open surgery and cut off colon cancer. The operation of the colon resection was carried out with the cooperation of laparoscopic operation in the laparoscopic group. The data of postoperative complications, postoperative quality of life and survival rate after surgery were statistically analyzed between the two groups.

Results

In the laparoscopic group, the mean operation time, bleeding amount, postoperative intestinal function recovery time, exhausting time, and hospitalization time were lower than those in the open group (t=11.182, 22.960, 6.420, 8.635, 16.850, all P<0.01). The postoperative complication rate was higher in the open group, with statistically significant difference (17.2% vs 2.0%, χ2=13.100, P=0.000). Five weeks after operation, the total quality of life of the laparoscopic group was better than that of the open group (P<0.01). For patients with stage Ⅱ colon cancer, the 5-year overall survival rate of the laparoscopic group was better than that of the open group.

Conclusion

Laparoscopic surgery for colon cancer is better than open surgery in terms of safety, clinical efficacy, and postoperative complication rate.

表1 两组结肠腺癌患者术中和术后相关指标比较( ± s
图4 两组患者Ⅲ期术后5年总体生存曲线
1
蒋磊,孙宏治,王巍,等.腹腔镜结肠癌根治术与开腹手术的临床疗效对比研究[J].中国全科医学, 2012, 15(8): 871-873.
2
胡伟文,陈星明,刘俊,等.腹腔镜与开腹手术治疗结肠癌疗效分析[J].中国医药导报, 2011, 8(14): 50-51.
3
彭吉绕.腹腔镜结肠癌根治术与传统术式可行性及安全性对比[J].中国现代普通外科进展, 2015, 18(2): 145-146.
4
Lim M,Hussain Z,Howe A, et al. The oncological outcome after right hemicolectomy and accuracy of CT Scan as a preoperative tool for staging in right sided colonic cancers[J]. Colorectal Dis, 2013, 15(5): 536-543.
5
Mori S,Kita Y,Baba K, et al. Laparoscopic complete mesocolic excision via reduced port surgery for treatment of colon cancer[J]. Dig Surg, 2015, 32(1): 45-51.
6
Erguner I,Aytac E,Baca B, et al. Total laparoscopic approach for the treatment of right colon cancer: a technical critique[J]. Plant Cell, 2013, 36(2): 2674-2689.
[1] 燕速, 霍博文. 腹腔镜食管胃结合部腺癌根治性切除术[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 13-13.
[2] 母德安, 李凯, 张志远, 张伟. 超微创器械辅助单孔腹腔镜下脾部分切除术[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 14-14.
[3] 李国新, 陈新华. 全腹腔镜下全胃切除术食管空肠吻合的临床研究进展[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 1-4.
[4] 李子禹, 卢信星, 李双喜, 陕飞. 食管胃结合部腺癌腹腔镜手术重建方式的选择[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 5-8.
[5] 李乐平, 张荣华, 商亮. 腹腔镜食管胃结合部腺癌根治淋巴结清扫策略[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 9-12.
[6] 陈方鹏, 杨大伟, 金从稳. 腹腔镜近端胃癌切除术联合改良食管胃吻合术重建His角对术后反流性食管炎的效果研究[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 15-18.
[7] 许杰, 李亚俊, 韩军伟. 两种入路下腹腔镜根治性全胃切除术治疗超重胃癌的效果比较[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 19-22.
[8] 李刘庆, 陈小翔, 吕成余. 全腹腔镜与腹腔镜辅助远端胃癌根治术治疗进展期胃癌的近中期随访比较[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 23-26.
[9] 刘世君, 马杰, 师鲁静. 胃癌完整系膜切除术+标准D2根治术治疗进展期胃癌的近中期随访研究[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 27-30.
[10] 任佳, 马胜辉, 王馨, 石秀霞, 蔡淑云. 腹腔镜全胃切除、间置空肠代胃术的临床观察[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 31-34.
[11] 赵丽霞, 王春霞, 陈一锋, 胡东平, 张维胜, 王涛, 张洪来. 内脏型肥胖对腹腔镜直肠癌根治术后早期并发症的影响[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 35-39.
[12] 李华志, 曹广, 刘殿刚, 张雅静. 不同入路下行肝切除术治疗原发性肝细胞癌的临床对比[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 52-55.
[13] 王庆亮, 党兮, 师凯, 刘波. 腹腔镜联合胆道子镜经胆囊管胆总管探查取石术[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(02): 313-313.
[14] 杨建辉, 段文斌, 马忠志, 卿宇豪. 腹腔镜下脾部分切除术[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(02): 314-314.
[15] 叶劲松, 刘驳强, 柳胜君, 吴浩然. 腹腔镜肝Ⅶ+Ⅷ段背侧段切除[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(02): 315-315.
阅读次数
全文


摘要