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腹腔镜辅助手术与开放手术治疗结直肠癌的临床疗效比较。

Comparison of the clinical outcomes of laparoscopic-assisted versus open surgery for colorectal cancer.

作者信息

Chen Kai, Zhang Zhuqing, Zuo Yunfei, Ren Shuangyi

机构信息

Department of General Surgery, The Second Hospital of Dalian Medical University, Dalian, Liaoning 116023, P.R. China.

Department of Clinical Biochemistry, College of Laboratory Diagnostic Medicine, Dalian Medical University, Dalian, Liaoning 116044, P.R. China.

出版信息

Oncol Lett. 2014 Apr;7(4):1213-1218. doi: 10.3892/ol.2014.1859. Epub 2014 Feb 7.

Abstract

The present study aimed to compare the clinical outcomes of laparoscopic-assisted surgery versus open surgery for colorectal cancer and investigate the oncological safety and potential advantages and disadvantages of laparoscopic-assisted surgery for colorectal cancer. The medical records from a total of 160 patients who underwent surgery for colorectal cancer between January 2009 and January 2013 at The Second Hospital of Dalian Medical University (Dalian, China) were retrospectively analyzed. The patients who underwent laparoscopic-assisted surgery showed significant advantages due to the minimally invasive nature of the surgery compared with those who underwent open surgery, namely, less blood loss (P=0.002), shorter time to flatus (P<0.001), bowel movement (P=0.009) and liquid diet intake (P=0.015), earlier ambulation time (P=0.006), smaller length of incision (P<0.001) and a shorter post-operative hospital stay (P=0.007). However, laparoscopic-assisted surgery for colorectal cancer resulted in a longer operative time (P=0.015) and higher surgery expenditure (P=0.003) and total hospitalization costs (P<0.001) compared with open surgery. There were no statistically significant differences between the intraoperative and post-operative complications. There were no differences in the local recurrence (P=0.699) or distant metastasis (P=0.699) rates. In addition, no differences were found in overall survival (P=0.894) and disease-free survival (P=0.701). These findings indicated that laparoscopic-assisted surgery for colorectal cancer had the clear advantages of a minimally invasive surgery and relative disadvantages, including a longer surgery time and higher cost, and exhibited similar rates of recurrence and survival compared with open surgery.

摘要

本研究旨在比较腹腔镜辅助手术与开放手术治疗结直肠癌的临床疗效,并探讨腹腔镜辅助手术治疗结直肠癌的肿瘤学安全性及潜在优缺点。回顾性分析了2009年1月至2013年1月在大连医科大学附属第二医院(中国大连)接受结直肠癌手术的160例患者的病历。与接受开放手术的患者相比,接受腹腔镜辅助手术的患者因手术的微创性而显示出显著优势,即失血量更少(P = 0.002)、排气时间更短(P < 0.001)、排便时间(P = 0.009)和流食摄入时间(P = 0.015)更早、下床活动时间更早(P = 0.006)、切口长度更小(P < 0.001)以及术后住院时间更短(P = 0.007)。然而,与开放手术相比,腹腔镜辅助结直肠癌手术导致手术时间更长(P = 0.015)、手术费用更高(P = 0.003)以及总住院费用更高(P < 0.001)。术中及术后并发症之间无统计学显著差异。局部复发率(P = 0.699)或远处转移率(P = 0.699)无差异。此外,总生存率(P = 0.894)和无病生存率(P = 0.701)也无差异。这些发现表明,腹腔镜辅助结直肠癌手术具有微创手术的明显优势和相对劣势,包括手术时间更长和成本更高,并且与开放手术相比,复发率和生存率相似。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ae7/3961342/edfd463a2bde/OL-07-04-1213-g00.jpg

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