摘要
目的观察腹腔镜联合同期开放术治疗同时性结直肠癌肝转移(sCRLM)的近远期疗效。方法选取2016年1月至2018年5月联勤保障部队第九○四医院收治的行同期切除手术治疗的116例sCRLM患者,依据所选手术方式的不同分为研究组(腹腔镜联合同期开放术,62例)和对照组(同期开放术,54例)。对比2组患者手术时间、术中出血量、住院时间、术前、术后1周肝功能指标[血清白蛋白(ALB)、天冬氨酸转氨酶(AST)及丙氨酸转氨酶(ALT)]和术后并发症发生率。随访3年,统计2组患者预后情况。结果2组患者手术时间比较,差异无统计学意义(P>0.05),但研究组术中出血量少于对照组(P<0.05),住院时间短于对照组(P<0.05)。术后1周2组患者ALB、AST及ALT水平均降低(P<0.05)。2组患者术后并发症发生率对比,差异无统计学意义(P>0.05)。截止3年随访结束,研究组、对照组总存活率分别为88.33%、77.36%。2组患者总存活率曲线比较,差异无统计学意义(P>0.05)。结论腹腔镜联合同期开放术治疗sCRLM可降低术中出血量和住院时间,在术后肝功能、并发症发生率及远期预后方面与同期开放术效果相当,值得在临床中进行推广应用。
Objective To observe the short‐and long‐term effects of laparoscopy combined with simultaneous open surgery in treatment of simultaneous colorectal cancer liver metastasis(sCRLM).Methods A total of 116 patients with sCRLM who were admitted to No.904 Hospital Joint Logistics Support Force hospital from January 2016 to May 2018 and expected to undergo simultaneous resection were divided into the study group(the laparoscopic combined with simultaneous open surgery group(n=62)and the control group(open surgery within the same time span(n=54).The operation time,intraoperative blood loss and hospital stay were compared between the two groups.The liver function indexes,such as serum albumin(ALB),aspartate aminotransferase(AST)and alanine aminotransferase(ALT)]before surgery and 1 week after surgery were compared between the two groups.The rate of complications after surgery was also compared between the two groups.The patients all had 3‐year medical follow‐ups and prognosis was statistically analyzed in the patients of the 2 groups.Results There was no statistical significance in surgical time,when comparisons were made between the patients of the two groups(P>0.05),however the amount of blood loss in the study group was less than that of the control group(P<0.05),and hospital stay was shorter than that of the control group(P<0.05).The ALB,AST and ALT levels of the two groups all decreased in the first week after surgery(P<0.05).There was no statistical significance in the rate of postoperative complications,when comparisons were made between the patients of the two groups(P>0.05).By the end of the 3‐year follow‐ups,the overall survival rates of the study group and control group were 88.33%and 77.36%respectively.There was also no statistical significance in the overall survival rate curve,when comparisons were made between the two groups(P>0.05).Conclusion Laparoscopy combined with simultaneous open surgery in treatment of sCRLM features less blood loss and shorter hospital stay.It could achieve same effects
作者
王家淳
姚豪杰
Wang Jiachun;Yao Haojie(Department of General Surgery,No.904 Hospital,Joint Logistics Support Force,Wuxi 214000,China)
出处
《海军医学杂志》
2023年第2期168-172,共5页
Journal of Navy Medicine
关键词
腹腔镜
同期开放术
同时性结直肠癌肝转移
疗效
Laparoscopy
Simultaneous open surgery
Simultaneous colorectal cancer liver metastasis
Curative effect
