目的：比较开腹手术与腹腔镜手术治疗结直肠癌的远期疗效及对患者生活质量的影响。方法：选择2009年7月至2011年6月收治的157例结直肠癌患者，采用χ2检验、Kaplan-Meier曲线法、Log rank检验及Student’ s t检验比较腹腔镜组与开腹组的术后并发症、肿瘤复发率、5年生存率（期）及生活质量。结果：并发症严重程度两组差异有统计学意义（Z＝8．243，P＝0．023），腹腔镜组更轻、开腹组更重；两组肿瘤复发率及复发类型差异无统计学意义（P＞0．05）；腹腔镜组5年总生存率为38．03％，中位生存时间为41个月，开腹组为46．51％及43个月，两组相比差异无统计学意义（ Log rankχ2＝0．749，P＝0．387，HR＝0．823，95％CI：0．523-1．296）。腹腔镜组Karnofsky评分显著高于开腹组（t＝2．305，P＝0．022）。结论：虽然与开腹手术相比，腹腔镜手术并不能显著延长患者生存期、提高5年生存率，但其并发症更轻，患者生活质量更好，临床可优先考虑选择腹腔镜治疗可手术的结直肠癌。%Objective:To compare the long-term efficacy and quality of life between laparoscopic and open surgery for patients with colorectal carcinoma.Methods:During Jul.2009 and Jun.2011,157 patients with colorectal cancer were included and followed up to Jul.1,2014.Chi-square test,Kaplan-Meier curves,Log rank test and Student’s t test were used to compare the postoperative compli-cations,tumor recurrence rate,five-year overall survival and quality of life between laparoscopic group and open group.Results:Laparo-scopic group had significantly lighter severity of complications than open group (Z=8.243,P=0.023);recurrence rates and the types of recurrence were not significantly different between the two groups ( P>0.05);5-year overall survival rate and median survival time was 38.03%and 41 months in laparoscopic group,46.51%and 43 months in open group,there was no significant difference (Log rankχ2 =0.749,P=0.387,HR=0.823,95%CI:0.523-1.296);Karnofsky score in laparoscopic group was significantly higher than that in open group (t=2.305,P=0.022).Conclusions:Compared with laparotomy,laparoscopic operation could not significantly prolong sur-vival time or improve 5-year survival rate,but its complications are lighter,and patients treated by laparoscopy have better quality of life,so laparoscopic treatment of colorectal cancer could be considered as the first choice.
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