腹腔镜与开腹结肠癌CME近期临床疗效比较
发布时间：2018-07-28 12:12
【摘要】：目的:以我院开腹完成完整结肠系膜切除术(CME)患者的临床资料为标准,来说明腹腔镜完成该手术的近期临床效果。方法:本研究所选取的病例来源于我院普通外科,病例收集的时间从2012年1月开始,截止日期为2017年2月。严格按照纳入标准和排除标准,共收集到85例患者的病历资料。将纳入研究的结肠癌患者根据实施手术的方法分别研究,分为左半结肠癌CME和右半结肠癌CME。左半结肠癌组行腹腔镜左半结肠癌CME21例,开腹为34例。右半结肠癌组行腹腔镜结肠癌CME14例,开腹16例。在左半和右半结肠癌CME中分别比较腹腔镜和开腹两种术式在淋巴结清扫效果等方面的异同。结果:无论是在左半结肠癌CME还是在右半结肠癌CME手术组,腹腔镜完成该手术和开腹完成该手术后,清扫淋巴结的效果基本相当,术后并发症的发生率基本相同,在这些指标方面的差异无统计学意义(P0.05)。无论是在左半结肠癌CME还是在右半结肠癌CME组,腹腔镜完成该手术和开腹完成该手术,腹腔镜手术后胃肠功能的恢复相对较快,但在本研究中腹腔镜完成该手术的时间相对较长(P0.05)。手术出血量方面,在左半结肠癌CME中,腹腔镜手术出血量少(P0.05),在右半结肠癌CME中,腹腔镜和开腹完成该手术的效果相当(P0.05)。结论:在安全性方面(清扫淋巴结效果和术后并发症),腹腔镜和开腹完成该手术的效果相当。诸多方面的原因,本研究中腹腔镜完成该手术的时间相对较长,但胃肠功能的恢复方面,腹腔镜完成该手术的效果较好。手术出血量方面,在左半结肠癌CME中,腹腔镜手术出血量少,在右半结肠癌CME中,腹腔镜和开腹手术的效果相当。
[Abstract]:Objective: to evaluate the clinical effect of laparoscopy in patients with complete mesorectal resection (CME) according to the clinical data of patients undergoing complete laparoscopic surgery in our hospital. Methods: the selected cases were from general surgery in our hospital. The time of case collection began in January 2012 and the deadline was February 2017. A total of 85 patients were collected according to the inclusion criteria and exclusion criteria. Patients with colon cancer included in the study were divided into left colon cancer CME and right colon cancer CME according to the operative method. Left colon cancer group was treated with laparoscopic left colon cancer (CME21), 34 cases were open. In the right hemicolon group, laparoscopic colon cancer CME14 was performed in 16 patients. The results of lymph node dissection were compared between laparoscopy and laparotomy in CME of left and right colon cancer respectively. Results: whether in the left colon cancer CME group or the right colon cancer CME operation group, the effect of lymph node dissection was basically the same, and the incidence of postoperative complications was basically the same after laparoscopy and laparotomy. There was no significant difference in these indexes (P0.05). Whether in the left colon cancer CME group or the right colon cancer CME group, laparoscopy performed the operation and the laparotomy performed the operation, and the gastrointestinal function recovered relatively quickly after laparoscopic surgery. But in this study, laparoscopic surgery was completed relatively long time (P0.05). In the aspect of blood loss, in CME of left colon cancer, the amount of bleeding in laparoscopic surgery was less (P0.05), in CME of right colon cancer, the effect of laparoscopy and laparotomy was similar (P0.05). Conclusion: in terms of safety (lymph node dissection and postoperative complications), laparoscopy and laparotomy are equally effective. In this study, the laparoscopic operation took a long time to complete, but the recovery of gastrointestinal function was better. In the aspect of operative bleeding, laparoscopic surgery has less bleeding in CME of left colon cancer, and in CME of right colon cancer, the effect of laparoscopy and open surgery is equal.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735.35
本文编号：2150098
[Abstract]:Objective: to evaluate the clinical effect of laparoscopy in patients with complete mesorectal resection (CME) according to the clinical data of patients undergoing complete laparoscopic surgery in our hospital. Methods: the selected cases were from general surgery in our hospital. The time of case collection began in January 2012 and the deadline was February 2017. A total of 85 patients were collected according to the inclusion criteria and exclusion criteria. Patients with colon cancer included in the study were divided into left colon cancer CME and right colon cancer CME according to the operative method. Left colon cancer group was treated with laparoscopic left colon cancer (CME21), 34 cases were open. In the right hemicolon group, laparoscopic colon cancer CME14 was performed in 16 patients. The results of lymph node dissection were compared between laparoscopy and laparotomy in CME of left and right colon cancer respectively. Results: whether in the left colon cancer CME group or the right colon cancer CME operation group, the effect of lymph node dissection was basically the same, and the incidence of postoperative complications was basically the same after laparoscopy and laparotomy. There was no significant difference in these indexes (P0.05). Whether in the left colon cancer CME group or the right colon cancer CME group, laparoscopy performed the operation and the laparotomy performed the operation, and the gastrointestinal function recovered relatively quickly after laparoscopic surgery. But in this study, laparoscopic surgery was completed relatively long time (P0.05). In the aspect of blood loss, in CME of left colon cancer, the amount of bleeding in laparoscopic surgery was less (P0.05), in CME of right colon cancer, the effect of laparoscopy and laparotomy was similar (P0.05). Conclusion: in terms of safety (lymph node dissection and postoperative complications), laparoscopy and laparotomy are equally effective. In this study, the laparoscopic operation took a long time to complete, but the recovery of gastrointestinal function was better. In the aspect of operative bleeding, laparoscopic surgery has less bleeding in CME of left colon cancer, and in CME of right colon cancer, the effect of laparoscopy and open surgery is equal.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735.35
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