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外科研究与新技术 ›› 2014, Vol. 3 ›› Issue (3): 174-176.

• 论著 • 上一篇    下一篇

腹腔镜下直肠及乙状结肠癌根治术44例临床分析

沈韧斌   

  1. 南京医科大学附属苏州医院普外科
  • 收稿日期:2014-09-25 修回日期:2014-10-09 出版日期:2014-09-28 发布日期:2014-12-04
  • 通讯作者: 沈韧斌 E-mail:qingt_0@126.com

Clinical analysis of laparoscopic radical operation of rectal cancer on 44 patients with rectum or colorectal cancer

  • Received:2014-09-25 Revised:2014-10-09 Online:2014-09-28 Published:2014-12-04

摘要: 目的探讨腹腔镜下直肠及乙状结肠癌根治术在结直肠癌治疗的临床疗效,为结直肠癌临床治疗方案的制定提供参考。方法选取我院收治的结直肠癌患者90例,随机分为观察组44例和对照组46例。观察组的患者采用腹腔镜下直肠,乙状结肠癌根治术进行治疗。对照组患者接受开腹手术治疗,对比两组患者的手术时间、术中出血量、术后肛门首次排气时间、术后住院天数以及术后并发症的发生情况;通过随访,对比两组患者的无疾病进展生存期和中位生存期。结果对照组患者在术中出血量、术后肛门排气的时间以及术后的住院天数上,均明显多于腹腔镜组的患者,差异均有统计学意义(P<0.05)。观察组术后并发症发生率为9.09%,对照组术后并发症发生率为10.87%,两组患者术后并发症发生率的对比,差异没有统计学意义(P>0.05)。对照组无疾病进展生存期为9个月(95%置信区间为5.6~11.8个月),中位生存期为22.7个月(95%置信区间为17.2~29.4个月);观察组无疾病进展生存期为12.5个月(95%置信区间为8.4~17.6个月),中位生存期为34.3个月(95%置信区间为25.6~33.4个月),均显著长于对照组(均P<0.05)。结论腹腔镜下直肠及乙状结肠癌根治术有助于提高结直肠癌的临床疗效,改善患者的预后,延长患者生存期,且不增加手术风险,安全性好。

Abstract: ObjectiveTo investigate the clinical effect of laparoscopic rectum, sigmoid colon cancer radical operation on rectum or colorectal cancer, and to provide reference for clinical treatment of colorectal cancer. Methods 90 patients with colorectal carcinoma in our hospital were selected. They were randomly divided into the observation group 44 cases and control group with 46 cases. The observation group was treated by laparoscopic rectum, sigmoid colon cancer radical resection for treatment. The control group received laparotomy operation treatment, The operation time, intraoperative bleeding volume, postoperative anal exhaust time, postoperative hospital stay and postoperative complications; survival through follow-up of both groups were compared. Results The amount of bleeding, the intraoperative and postoperative anal exhaust time and postoperative hospitalization of the control group were significantly more than those in the laparoscopic group, the difference was statistically significant (P < 0.05). The complication rate was 9.09% in observation group, while it was 10.87% in the control group, the difference was not statistically significant (P > 0.05). The progression free survival of control group was 9 months (95% confidence interval, 5.6~11.8 months), the median survival was 22.7 months (95% confidence interval, 17.2~29.4 months); while it was 12.5 months (95% confidence interval, 8.4~17.6 months) in the observation group, the median survival period for 34.3 months (95% confidence interval, 25.6~33.4 months), it was significantly longer than that in the control group (P < 0.05). Conclusion Laparoscopic rectum, sigmoid colon cancer radical resection is helpful to improve the clinical efficacy of colorectal cancer, can improve the prognosis of patients, prolong the survival of patients with and without increasing the risk, operation, good safety.