腹腔镜手术和经腹直肠癌根治术治疗左、右侧大肠癌的临床疗效分析

摘要

Objective To analyze the differences of clinical effects between laparoscopy and traditional abdominal radical resection of rectal carcinoma for the left and right carcinoma of large intestine. Methods Two hundred cases who underwent laparoscopy and 200 cases who underwent traditional abdominal radical resection of rectal carcinoma were selected in the study. The clinical data of them were analyzed retrospectively. The differences of operation time, bleeding volume, time of digestive function recovery, length of stay, postoperative complications, metastasis and relapse rate and five years disease free survival rate were compared between left and right carcinoma of large intestine. Results The operation time,bleeding volume,time of digestive function recovery, length of stay and postoperative complications were lower in patients with laparoscopy than those in patients with traditional abdominal radical resection of rectal carcinoma(P <0. 05). The differences in operation time,bleeding volume, time of digestive function recovery, length of stay and postoperative complications between left and right carcinoma of large intestine were not significant( P>0. 05 ). The metastasis and relapse rate and five years disease free survival rate of right carcinoma of large intestine patients with laparoscopy and traditional abdominal radical resection of rectal carcinoma showed no significant difference ( P > 0. 05 ) . The metastasis and relapse rate of left carcinoma of large intestine patients with laparoscopy and traditional abdominal radical resection of rectal carcinoma showed no significant difference(P >0.05) ;but the five years disease free survival rate in the patients with laparoscopy was higher than that in the patients with traditional abdominal radical resection of rectal carcinoma( P < 0. 05 ) . Conclusion The clinical effects of laparoscopy were superior to traditional abdominal radical resection of rectal carcinoma, especially in improving the five years disease free survival rate of left carcinoma of large intestine.%目的 分析腹腔镜手术和经腹直肠癌根治术治疗左、右侧大肠癌临床效果的差异.方法 回顾性分析200例腹腔镜手术和200例经腹直肠癌根治术治疗左、右侧大肠癌患者的临床资料,比较2种手术方式对大肠癌患者的手术时间、出血量、排气时间、术后住院时间、术后并发症、转移复发率及5 a无瘤生存率的差异.结果 腹腔镜手术患者的手术时间、出血量、排气时间、术后住院时间及术后并发症均少于经腹直肠癌根治术患者(P＜0.05).左、右侧大肠癌患者的手术时间、出血量、排气时间、术后住院时间及术后并发症比较差异均无统计学意义(P＞0.05).右侧大肠癌患者,腹腔镜手术和经腹直肠癌根治术的转移复发率和5 a无瘤生存率比较差异无统计学意义(P＞0.05)；左侧大肠癌患者,腹腔镜手术和经腹直肠癌根治术的转移复发率比较差异无统计学意义(P＞0.05),但腹腔镜手术5 a无瘤生存率高于经腹直肠癌根治术,差异有统计学意义(P＜0.05).结论 腹腔镜手术治疗大肠癌临床效果优于经腹直肠癌根治术,尤其在提高左侧大肠癌患者的5 a无瘤生存率方面疗效明显.