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。
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.
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