腹腔鏡完整結(jié)腸系膜切除術(shù)治療結(jié)腸癌臨床觀察

張成雷　陳康壽　陳敏

【摘要】 目的：探討腹腔鏡完整結(jié)腸系膜切除術(shù)治療結(jié)腸癌的臨床效果。方法：選取2014年

2月-2016年2月本院收治的結(jié)腸癌患者104例，按照隨機(jī)數(shù)字表法將其分成觀察組和對照組，每組52例。對照組采用開腹完整結(jié)腸系膜切除術(shù)治療，觀察組采用腹腔鏡下完整腸系膜切除術(shù)治療，比較兩組患者手術(shù)過程中的持續(xù)時(shí)間、出血量、術(shù)后肛門排氣時(shí)間、住院天數(shù)及并發(fā)癥發(fā)生情況等。對兩組患者均隨訪1年，觀察兩組患者的腫瘤復(fù)發(fā)率。結(jié)果：觀察組與對照組手術(shù)時(shí)間比較，差異無統(tǒng)計(jì)學(xué)意義（P=0.076）；觀察組術(shù)中出血量、術(shù)后排氣時(shí)間與住院天數(shù)均少于對照組，比較差異均有統(tǒng)計(jì)學(xué)意義（P<0.05），觀察組并發(fā)癥發(fā)生率3.85%（2/52）低于對照組，差異有統(tǒng)計(jì)學(xué)意義（字2 =7.121，P=0.008）；術(shù)后對兩組患者均進(jìn)行1年隨訪，觀察組復(fù)發(fā)率為1.92%（1/52），對照組復(fù)發(fā)率為15.38%（8/52），觀察組腫瘤復(fù)發(fā)率顯著低于對照組，差異有統(tǒng)計(jì)學(xué)意義（字2=5.960，P=0.015）。結(jié)論：采用腹腔鏡下完整結(jié)腸系膜切除術(shù)治療結(jié)腸癌效果顯著，具有手術(shù)時(shí)間短、術(shù)中出血量少、住院時(shí)間、并發(fā)癥發(fā)生率低等優(yōu)點(diǎn)，且術(shù)后1年內(nèi)腫瘤復(fù)發(fā)率也較低，具有重要的臨床推廣價(jià)值。

【關(guān)鍵詞】 腹腔鏡； 完整腸系膜切除術(shù)； 結(jié)腸癌

【Abstract】 Objective：To investigate the clinical effect of laparoscopic total mesorectal excision in the treatment of colon cancer.Method：From February 2014 to February 2016，104 colon cancer patients treated in our hospital were selected as the research objects，they were divided into observation group and control group according to random number table method，52 cases in each group.Control group was given open complete mesocolic excision treatment，and observation group with complete mesenteric laparoscopic resection，observed and compared the operation time，surgery bleeding volume，postoperative anal exhaust time，hospitalization time and complications occurrence rate of two groups.Two groups were followed up for 1 year，the recurrence rate of two groups were observed.Result：The operation time of two groups were no significant difference（P=0.076）；surgery bleeding volume，postoperative anal exhaust time，hospitalization time of observation group were less than those of control group，the differences were statistically significant（P<0.05）；complications occurrence rate of observation group was 3.85%（2/52），lower than that of control group，the different was statistically significant（字2 =7.121，P=0.008）.The two groups of patients were followed up for a period of 1 year，the recurrence rate of observation group was 1.92%（1/52），lower than that of control group 15.38%（8/52），the difference was statistically significant（字2=5.960，P=0.015）.Conclusion：Laparoscopic complete mesocolic resection in the treatment of colon cancer has significant effect，has a shorter operative time，less bleeding， hospitalization time，low complication occurrence rate，and postoperative 1 year recurrence rate is low，has important clinical value.

【Key words】 Laparoscopy； Complete mesenteric resection； Colon cancer

First-authors address：Zhanjiang Central Peoples Hospital，Zhanjiang 524000，China

doi：10.3969/j.issn.1674-4985.2017.25.032endprint

近年來，隨著生活節(jié)奏的加快，人們飲食結(jié)構(gòu)和作息規(guī)律也越來越不合理，致使結(jié)腸癌的發(fā)病率呈逐年上升的趨勢，對患者的生活質(zhì)量及生命造成嚴(yán)重威脅[1-4]。目前，臨床上主要采用手術(shù)方法治療結(jié)腸癌，隨著醫(yī)療水平的提高，微創(chuàng)技術(shù)也得到不斷發(fā)展，越來越受到患者的好評[5]。為了探討腹腔鏡完整結(jié)腸系膜切除術(shù)治療結(jié)腸癌的臨床效果，本院選取在2014年2月-2016年2月收治的104例結(jié)腸癌患者為研究對象，分別采用開腹完整結(jié)腸系膜切除術(shù)和腹腔鏡下完整腸系膜切除術(shù)，效果顯著，現(xiàn)報(bào)道如下。

1 資料與方法

1.1 一般資料 選取在2014年2月-2016年2月本院收治的結(jié)腸癌患者104例，所選患者均進(jìn)行全面檢查而確診，并經(jīng)本院倫理委員會(huì)批準(zhǔn)，簽署患者知情同意書?！?br>