外科理论与实践

外科理论与实践 ›› 2018, Vol. 23 ›› Issue (02): 145-149.doi: 10.16139/j.1007-9610.2018.02.013

• 论著 • 上一篇    下一篇

腹腔镜与开腹右半结肠癌全结肠系膜切除术的回顾性临床对照研究

俞旻皓, 祁洋, 秦绍岚, 慕逸飞, 骆洋, 仇伊尔, 崔然, 钟鸣   

  1. 上海交通大学医学院附属仁济医院胃肠外科,上海 200127
  • 收稿日期:2017-10-30 出版日期:2018-03-25 发布日期:2020-07-25
  • 通讯作者: 钟鸣,E-mail: drzhongming1966@163.com
  • 基金资助:
    上海交通大学医学院附属仁济医院临床科研创新培育基金（PYZY16-016）

A retrospective controlled clinical study on laparoscopic versus open complete mesocolic excision for right colon cancer

YU Minhao, QI Yang, QIN Shaolan, MU Yifei, LUO Yang, QIU Yier, CUI Ran, ZHONG Ming   

  1. Department of Gastrointestinal Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
  • Received:2017-10-30 Online:2018-03-25 Published:2020-07-25

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摘要： 目的 比较腹腔镜与开腹右半结肠癌全结肠系膜切除术的疗效。方法 回顾性分析2010年1月至2014年12月我院胃肠外科全结肠系膜切除的右半结肠癌病人。其中腹腔镜组病人102例,开腹组病人116例,比较两组病人的手术结果及生存。结果 两组病人基线资料未见统计学差异（P>0.05）。腹腔镜组手术时间较开腹组长[（155.20±4.17） min比（140.10±4.00） min,P=0.009 6],但术中出血量较少[（102.60±7.37） mL比（145.90±12.23） mL,P=0.003 7],清扫淋巴结数目较多[（12.17±0.39）枚比（10.78±0.42）枚,P=0.016 8]。腹腔镜组术后恢复流质时间较短[（2.91±0.47） d比（3.62±0.41） d,P=0.034],术后住院时间较短[（10.59±0.57） d比（14.13±0.52） d,P=0.041]。两组术后并发症发生无统计学差异。腹腔镜组随访时间为（38.83±1.73）个月,开腹组为（30.74±1.60）个月,无统计学差异（P>0.05）。腹腔镜组3年生存率明显优于开腹组（89.81%比82.22%,P=0.048 2）。结论 对于右半结肠癌病人,腹腔镜全结肠系膜切除术较开腹术恢复快,手术疗效佳。

关键词: 腹腔镜, 开腹, 右半结肠癌, 全结肠系膜切除术

Abstract: Objective To compare the efficacy of laparoscopic complete mesocolic excision (CME) for right colon cancer with open CME. Methods The clinical data of the patients with right colon cancer in our department from January 2010 to December 2014 was retrospectively analyzed. There were 102 patients with laparoscopic CME as laparoscopic group and 116 patients with open CME as open group. Peri-operative outcomes and survival were compared between two groups. Results The baseline information was not significantly different between two groups (P> 0.05). Compared with open group, the patients in laparoscopic group had longer operating time [(155.20± 4.17) min vs (140.10± 4.00) min, P=0.009 6], but less bleeding [(102.60± 7.37) mL vs(145.90± 12.23) mL, P=0.003 7], more retrieved lymph nodes [(12.17± 0.39) vs(10.78± 0.42), P=0.016 8], faster recovery course including shorter time to liquid diet [(2.91± 0.47) day vs (3.62± 0.41) day, P=0.034] and shorter postoperative hospital stay [(10.59± 0.57) day vs (14.13± 0.52) day, P=0.041]. No significant difference was observed in the postoperative complications between two groups. The period of follow-up had no significant difference between two groups [(38.83± 1.73) month vs (30.74± 1.60) month, P> 0.05]. Three-year survival rate of the patients in laparoscopic group was significantly higher than that in open group (89.81% vs 82.22%, P=0.048 2). Conclusions Laparoscopic CME provides the patients of right colon cancer with faster recovery and better overall survival.

Key words: Laparoscopic surgery, Open surgery, Right colon cancer, Complete mesocolic excision

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