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目的评价腹腔镜手术与传统开腹手术治疗结直肠癌的疗效。方法 2006年6月至2007年1月北京大学临床肿瘤学院腹部肿瘤微创外科共实施腹腔镜结直肠癌手术29例,同时选取同一时期行传统开腹结直肠癌手术30例,回顾性比较两组根治性、手术时间、术中及术后并发症、术后肠道功能恢复时间等情况。结果两组均按照肿瘤根治性原则进行手术,包括切除范围及肿瘤距切缘距离等方面。腹腔镜组与开腹组比较,在手术时间、术中出血、术后肠道功能恢复时间、术后住院时间等差异有统计学意义。而术中及术后并发症、淋巴结清扫数目、30d病死率、2年总存活率及无病存活率差异无统计学意义。结论对于可治愈性结直肠癌,腹腔镜手术是一种适宜的方式,可获得与传统开腹手术相同的短期及根治效果。尽管腹腔镜手术时间较长,但在术中出血、术后肠道功能恢复时间及术后住院时间方面体现了优势。腹腔镜手术的长期预后尚需随访。
Objective To evaluate the efficacy of laparoscopic surgery and traditional laparotomy in the treatment of colorectal cancer. Methods From June 2006 to January 2007, a total of 29 cases of laparoscopic colorectal cancer surgery underwent minimally invasive abdominal surgery in the Department of Oncology, School of Oncology, Peking University, and 30 cases of conventional open surgery for colorectal cancer during the same period. The retrospective comparison of two Radical group, operation time, intraoperative and postoperative complications, postoperative intestinal function recovery time and so on. Results The two groups were operated according to the radical principle of tumor, including the scope of resection and the distance of the tumor from the cutting edge. Laparoscopic group and laparotomy group compared the operation time, intraoperative bleeding, postoperative recovery time of intestinal function, postoperative hospital stay and other differences were statistically significant. The intraoperative and postoperative complications, the number of lymph node dissection, 30d mortality, 2-year overall survival and disease-free survival rate was no significant difference. Conclusions Laparoscopic surgery is a suitable modality for curable colorectal cancer with the same short-term and radical effects as conventional laparotomy. Although laparoscopic surgery took longer, it showed advantages in intraoperative bleeding, postoperative recovery of intestinal function and postoperative hospital stay. The long-term prognosis of laparoscopic surgery remains to be followed up.