Comparison of laparoscopic surgery and laparotomy on the clinical efficacy and coagulation status of gastrointestinal cancer patients

doi:10.3877/cma.j.issn.1674-0793.2015.04.013

Abstract

Abstract:

Objective

To compare the effect of laparoscopic surgery and laparotomy in gastrointestinal cancer patients, and to analyze the effect of both therapies on the coagulation status.

Methods

One hundred and twenty patients with gastrointestinal cancer between January 2013 and December 2014 were selected and divided into laparoscopic group and open surgery group according to different surgical methods. The clinical effect of both groups were observed and coagulation parameters were detected.

Results

The operation time, blood loss, gastrointestinal function recovery time and hospital stay of laparoscopic group were significantly lower than those of laparotomy group, the differences were statistically significant(P<0.05). 1 h, 24 h postoperative prothrombin time and D-dimer level changed in the two groups, and the changes in laparoscopic group were significantly bigger (P<0.05). The postoperative complication incidence in the laparoscopic group and open surgery group was 9.2% and 25.5%, respectively(P<0.05).

Conclusion

Compared with laparotomy, laparoscopic surgery has less trauma and fewer complications for gastrointestinal cancer patients. Since both surgeries can lead to high coagulation status, especially for laparoscopic surgery, a rational choice should be made based on the individual physical condition.

Key words: Laparoscopy, Laparotomy, Gastrointestinal tumors, Coagulation status

Shaohua Zhu. Comparison of laparoscopic surgery and laparotomy on the clinical efficacy and coagulation status of gastrointestinal cancer patients[J]. Chinese Archives of General Surgery(Electronic Edition), 2015, 09(04): 307-310.

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Figures/Tables 2

References 15

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组别	例数	手术时间(min)	术中出血量(ml)	胃肠功能恢复时间(d)	住院时间(d)
腹腔镜组	65	99.8±13.4	48.1±5.3	3.2±0.5	7.7±1.0
开腹组	55	124.3±15.1	123.9±11.8	4.9±0.7	10.4±1.3
t值	?	17.563	10.312	3.014	4.132
P值	?	<0.05	<0.05	<0.05	<0.05

组别	例数	手术时间(min)	术中出血量(ml)	胃肠功能恢复时间(d)	住院时间(d)
腹腔镜组	65	99.8±13.4	48.1±5.3	3.2±0.5	7.7±1.0
开腹组	55	124.3±15.1	123.9±11.8	4.9±0.7	10.4±1.3
t值	?	17.563	10.312	3.014	4.132
P值	?	<0.05	<0.05	<0.05	<0.05

组别	例数	时间	APTT（s）	PT（s）	D-D（μg／L）	INR
腹腔镜组	65	术前	29.5±3.3	12.7±0.7	219.4±21.8	1.1±0.2
?	?	术后1 h	28.9±2.8	10.6±0.5^a	378.5±27.3^a	1.0±0.3
?	?	术后24 h	28.5±3.9	10.2±0.4^a	412.6±30.5^a	1.0±0.2
开腹组	55	术前	28.7±4.2	12.4±0.8	214.9±20.8	1.1±0.3
?	?	术后1 h	28.9±4.2	10.2±0.4^a	351.6±22.8^ab	1.0±0.2
?	?	术后24 h	29.1±4.4	10.1±0.3^a	389.3±24.4^ab	1.0±0.2

组别	例数	时间	APTT（s）	PT（s）	D-D（μg／L）	INR
腹腔镜组	65	术前	29.5±3.3	12.7±0.7	219.4±21.8	1.1±0.2
?	?	术后1 h	28.9±2.8	10.6±0.5^a	378.5±27.3^a	1.0±0.3
?	?	术后24 h	28.5±3.9	10.2±0.4^a	412.6±30.5^a	1.0±0.2
开腹组	55	术前	28.7±4.2	12.4±0.8	214.9±20.8	1.1±0.3
?	?	术后1 h	28.9±4.2	10.2±0.4^a	351.6±22.8^ab	1.0±0.2
?	?	术后24 h	29.1±4.4	10.1±0.3^a	389.3±24.4^ab	1.0±0.2

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