腹腔镜结肠癌切除术对比开腹手术的安全性和长期生存分析

被引：49

作者：

赵丽瑛

王亚楠

余江

邓海军

胡彦锋

牟廷裕

李国新

机构：

[1] 南方医科大学南方医院普通外科

来源：

中华外科杂志 | 2013年 / 04期

关键词：

结肠肿瘤; 腹腔镜检查; 存活率分析;

D O I：

暂无

中图分类号：

R735.35 [];

学科分类号：

摘要：

目的评估腹腔镜结肠癌切除术的临床疗效及患者预后情况。方法对比2003年3月至2008年7月行腹腔镜结肠癌切除术的92例患者(腹腔镜组)和同期行开腹手术的285例患者(开腹组)的临床、病理资料;比较2组患者的5年局部复发率、总体生存率和无瘤生存率等术后长期随访结果。结果腹腔镜结肠癌切除术在减少术中出血量[50(50)ml]、加快术后消化道功能恢复方面[术后排气时间(3.0±1.0)d,术后进食时间(4.0±1.3)d]较开腹组均有显著优势(Z=-8.292,t=-6.475、-4.871,P<0.01)。腹腔镜组标本的远端切缘长度[(10±4)cm]较开腹组[(9±4)cm]明显延长(t=3.527,P=0.000)。腹腔镜结肠癌切除术和开腹结肠癌切除术患者的术后5年累积总体生存率分别为63.6%和61.8%;Ⅰ～Ⅲ期患者的5年累积局部复发率分别为8.7%和13.6%,无瘤生存率分别为69.5%和65.5%,差异均无统计学意义(P>0.05)。结论腹腔镜结肠癌切除术安全可行,其长期肿瘤生存结果与传统开腹手术近似。

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