手辅助腹腔镜、腹腔镜辅助和开腹结直肠癌手术近期疗效的比较

发布时间：2018-04-02 23:26

本文选题：手辅助腹腔手术　切入点：腹腔镜辅助手术　出处：《中国医科大学学报》2017年02期

【摘要】：目的比较手辅助腹腔镜手术(HALS)和腹腔镜辅助手术(LAS)以及开腹手术(OS)在结直肠癌中的近期临床疗效。方法回顾性分析2011年10月至2015年12月我科由同一组医师采用3种术式完成治疗的74例结直肠癌患者的临床资料,比较3组患者的术后近期临床疗效,包括术中指标、术后恢复情况、术后并发症、肿瘤根治性和住院费用。结果最终纳入HALS组24例患者,LAS组和OS组各25例患者,3组患者的一般资料和肿瘤基线具有可比性。对比结果显示,OS组、HALS组和LAS组的手术时间依次增加,切口长度依次缩短(P0.05);HALS组的戳卡数少于LAS组(P0.05),2组的中转率无统计学差异(P0.05)。在术后恢复、术后并发症发生率和肿瘤根治性方面,3组无统计学差异(P0.05)。在住院费用方面,HALS组和LAS组的总费用和手术费高于OS组(P0.05),而HALS组和LAS组之间无统计学差异(P0.05);对于材料费,OS组、HALS组和LAS组依次增加(P0.05);其他费用明细3组之间无统计学差异(P0.05)。结论 3种术式各具优势,既相互独立又能互相补充,临床医师可根据个人掌握程度和患者情况选择合理术式。
[Abstract]:Objective to compare the clinical effects of hand-assisted laparoscopic surgery (HALS), laparoscopic assisted surgery (LAS) and open surgery (OS) in colorectal cancer.Methods from October 2011 to December 2015, the clinical data of 74 patients with colorectal cancer treated by the same group of doctors were analyzed retrospectively, and the short-term clinical effects, including intraoperative indexes, were compared among the three groups.Postoperative recovery, postoperative complications, tumor radical and hospitalization costs.Results the general data and tumor baseline of 24 patients in HALS group and 25 patients in OS group were comparable.The results showed that the operation time of Hals group and LAS group increased in turn, and the number of postmark cards in Hals group was shorter than that in LAS group (P 0.05). There was no significant difference (P 0.05) in the conversion rate between Hals group and LAS group.There was no significant difference in the incidence of postoperative complications and radical tumor among the three groups (P 0.05).The total cost and operating cost of Hals and LAS group were higher than those of OS group, but there was no significant difference between HALS group and LAS group.Conclusion each of the three operations has its own advantages, which are independent and complementary to each other. The clinicians can choose a reasonable operation according to the degree of individual mastery and the patient's condition.
【作者单位】：中国医科大学附属第一医院胃肠外科/疝与腹壁外科;
【基金】：沈阳市科技局社发基金(F14-158-9-35)
【分类号】：R735.34

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