摘要
目的:探讨高龄右半结肠癌患者行腹腔镜全结肠系膜切除术的安全性、可行性。方法:回顾分析2006年1月至2017年1月收治的189例70岁以上右半结肠癌患者的临床资料,其中108例接受腹腔镜全结肠系膜切除术(研究组),81例接受腹腔镜传统结肠癌根治术(对照组),比较两组患者术前情况、手术相关指标及术后恢复指标。结果:两组患者术前一般情况差异均无统计学意义(P>0.05),两组均无手术相关死亡病例。研究组、对照组中转开腹率(4.6%vs. 4.9%)、手术时间[(174.3±47.4) min vs.(167.2±57.9) min]、术中出血量[(89.9±72.8) mL vs.(98.8±67.6) mL]、排气时间[(2.7±1.1) d vs.(3.0±1.3) d]、进食流质时间[(2.8±1.5) d vs.(3.2±1.9) d]、住院时间[(10.4±4.5) d vs.(11.2±5.5) d]、术后并发症发生率(21.3%vs.23.5%)差异均无统计学意义(P>0.05)。研究组淋巴结获取数量[(15.6±4.8) vs.(12.8±4.5)]多于对照组(P<0.01)。结论:腹腔镜全结肠系膜切除术治疗高龄右半结肠癌是安全、可行的,可取得更好的肿瘤学近期疗效。
Objective:To investigate the safety,feasibility of laparoscopic complete mesocolic excision(Lap-CME)in elderly patients with right-sided colon cancer.Methods:A retrospective analysis was conducted among 189 right-sided colon cancer patients who were over 70 years old from Jan.2006 to Jan.2017.108 patients underwent Lap-CME surgery and 81 patients underwent Lap-‘conventional’surgery.These two groups were compared with each other in terms of preoperative clinical data,details of operations and postoperative recovery.Results:No significant differences were found among preoperative clinical data(P>0.05).No surgery-related death occurred in Lap-CME group or Lap-‘conventional’group.There were no significant differences in the conversion rate(P>0.05),which was 4.6%in the Lap-CME group and 4.9%in the Lap-‘conventional’group.Average operative time[(174.3±47.4)min vs.(167.2±57.9)min],blood loss[(89.9±72.8)mL vs.(98.8±67.6)mL],time to flatus[(2.7±1.1)d vs.(3.0±1.3)d],time of liquid diet[(2.8±1.5)d vs.(3.2±1.9)d],hospital stay[(10.4±4.5)d vs.(11.2±5.5)d]of Lap-CME group were similar with those of Lap-‘conventional’group(P>0.05),respectively.Lymph node harvested was more in the Lap-CME group[(15.6±4.8)vs.(12.8±4.5),P<0.01].There was no difference in postoperative complications rate(P>0.05),which was 21.3%in the Lap-CME group and 23.5%in the Lap-‘conventional’group.Conclusions:Lap-CME for elderly patients with right-sided colon cancer can be performed safely and feasibly,and can achieve better short-term oncologic outcomes.
作者
曹金鹏
计勇
杨平
余思
李志澄
朱佳成
罗特东
CAO Jin-peng;JI Yong;YANG Ping(Department of Gastrointestinal Surgery,First People’s Hospital of Foshan,Foshan 528000,China)
出处
《腹腔镜外科杂志》
2018年第10期778-781,共4页
Journal of Laparoscopic Surgery
基金
广东省医学科研基金项目(编号:A2013665)
