腹腔镜与开腹全结肠系膜切除术治疗右半结肠癌的疗效比较

被引:37
作者
韩玉栋
宋京翔
林晨
张再重
涂小煌
机构
[1] 南京军区福州总医院普通外科
关键词
结肠肿瘤; 腹腔镜; 治疗结果; 全结肠系膜切除术;
D O I
暂无
中图分类号
R735.35 [];
学科分类号
摘要
目的比较腹腔镜与开腹全结肠系膜切除(complete mesocolic excision,CME)术治疗右半结肠癌的临床疗效。方法回顾性分析南京军区福州总医院2011年1月至2012年8月行全结肠系膜切除术的134例右半结肠癌患者的临床资料,134例中腹腔镜手术71例,开腹手术63例。对两组的手术学指标、肿瘤根治性指标和短期疗效进行对比分析。采用χ2检验及t检验进行数据分析。结果两组的近端切缘长度(P=0.427)、远端切缘长度(P=0.515)、肿瘤直径(P=0.440)及淋巴结清扫数目(P=0.377)的差异均无统计学意义。术后随访12个月,腹腔镜组和开腹组的局部复发率分别为4.2%(3/71)和1.6%(1/63)(P=0.622),远处转移率分别为5.6%(4/71)和3.2%(2/63)(P=0.684),差异均无统计学意义。两组手术时间(P=0.134)和术后并发症(P=0.977)的差异无统计学意义。腹腔镜组术中出血量(P=0.000)、排气时间(P=0.000)、平均住院时间(P=0.000)显著低于开腹手术组,差异有统计学意义。结论腹腔镜右半结肠癌CME手术能达到与传统开腹手术相同的根治效果和短期疗效,且具有创伤小、术中出血少、术后疼痛轻、康复快等优点。
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