摘要
目的探讨腹腔镜与开腹手术在结直肠癌术后吻合口瘘发病率的研究。方法方便选取2015年10月—2017年10月在该院外科手术治疗的120例结直肠癌患者按术式不同分为两组,对照组采用开腹手术,观察组采用腹腔镜手术,比较两组患者的手术疗效及术后并发症情况、吻合口瘘和非吻合口瘘的各项指标情况。结果观察组手术时间(3.84±0.32)h、淋巴结清扫数目(21.7±5.9)个、术后住院时间(13.4±1.9)d、再次手术率6.67%、术后肠梗阻率3.33%、心脑血管并发症率1.67%、栓塞率1.67%、其他并发症率11.67%与对照组的(3.76±0.30)h、(23.6±5.8)个、(14.2±1.7)d、8.33%、5.00%、3.33%、0.00%、15.00%相比均差异无统计学意义(t=0.706,0.894,0.879,χ~2=1.13,1.21,1.16,0.95,2.14,P>0.05),但观察组切口感染率10.00%、术中输血率13.33%明显低于对照组的23.33%、43.33%(χ~2=9.82,14.74,P<0.05);观察组结肠癌及直肠癌吻合口瘘发生率为9.09%、11.11%,与对照组的10.00%、13.33%相比差异无统计学意义(χ~2=1.05,1.18,P>0.05);吻合口瘘患者的切口感染率46.15%、其他并发症发生率38.46%、住院时间(25.1±3.4)d、再次入院手术率23.08%明显高于非吻合口瘘患者的13.08%、10.28%、(12.3±1.8)d、5.61%,差异有统计学意义(χ~2=14.67,11.76,t=5.986,χ~2=13.29,P<0.05)。结论腹腔镜与开腹手术在结直肠癌术后吻合口瘘发病率相当,腹腔镜具有创伤小、术后感染率低的优点,疗效及安全性更佳。
Objective This paper tries to investigate the incidence of anastomotic leakage after laparoscopic and open surgery in colorectal cancer. Methods 120 patients with colorectal cancer underwent surgical treatment in this hospital from October 2015 to October 2017 were selected conveniently divided into two groups according to different surgical methods.The control group used laparotomy, the observation group used laparoscopic surgery, compared the surgical outcomes, postoperative complications, anastomotic fistulas, and non-anastomotic fistulas in each group. Results The operation time of the observation group was（3.84±0.32）h, the number of lymph node dissection（21.7±5.9）, postoperative hospital stay（13.4±1.9）days, reoperation rate was 6.67%, the postoperative intestinal obstruction rate was 3.33%, and the cerebrovascular and cerebral vessels were complicated. The disease rate was 1.67%, the embolization rate was 1.67%, the other complication rate was 11.67%, and the control group was（3.76±0.30）h,（23.6±5.8）,（14.2±1.7）d, 8.33%, 5.00%, 3.33%, 0.00% and 15.00%,the difference was not statistically significant（t=0.706, 0.894, 0.879, χ^2=1.13, 1.21, 1.16, 0.95, 2.14, P〉0.05）, but the incision infection rate in the observation group was 10.00%, intraoperative blood transfusion rate 13.33% was significantly lower than the control group of 23.33%, 43.33%（χ^2=9.82, 14.74, P〈0.05）; the incidence of anastomotic leakage in colon and rectal cancer in the observation group was 9.09%, 11.11%, and 10.00%, 13.33% in the control group. the difference was not statistically significant（χ^2=1.05, 1.18, P〉0.05）; the incision infection rate was 46.15%, the incidence of other complications was 38.46%, the length of hospital stay was（25.1±3.4） days, the rate of hospital admission was 23.08%, which was significantly higher than that of non-anastomotic fistula patients [13.08%, 10.28%,（12.3±1.8） days, 5.61%]. The difference was statistically significant（χ^2=14.67, 11.76, t= 5.986,
作者
余振兴
王瑞华
郭登方
张扬平
YU Zhen-xing;WANG Rui-hua;GUO Deng-fang;ZHANG Yang-ping(Department of General Surgery,Jidong Hospital Affiliated to Fujian Medical University,Fuan,Fujian Province,355000 China)
出处
《中外医疗》
2018年第19期7-10,共4页
China & Foreign Medical Treatment
关键词
结直肠癌
腹腔镜
开腹手术
术后吻合口瘘发病率
Colorectal cancer
Laparoscopy
Open surgery
Incidence of postoperative anastomotic leakage
