腹腔镜肝切除在治疗结直肠癌肝转移中的研究应用

发布时间：2018-05-05 04:01

本文选题：腹腔镜肝切除 + 开腹肝切除　；参考：《浙江大学》2015年硕士论文

【摘要】：目的通过回顾性分析结直肠癌肝转移病例,对比腹腔镜肝切除和开腹肝切除的队列研究,探究腹腔镜在治疗结直肠癌肝转移中的应用。方法统计2011年1月1日至2014年12月31日期间于浙江大学医学院附属邵逸夫医院住院院治疗的结直肠癌肝转移病例20例。比较腹腔镜肝切除和开腹肝切除组的手术时间,术中出血及输血率,术后住院天数术,后肝功能恢复,并发症和长期随访结果。结果与开腹肝切除(OH)组相比,腹腔镜肝切除(LH)组平均手术时间247.22(50-360)分钟,略高于开腹组的205.63(110-360)分钟；而术中出血量,两组分别为305.0(50-800)ml和693.8(50-2000)ml,LH组出血明显少于OH组；LH组术后平均住院天数为10.2(5-23)天,明显小于开腹组的14.50(3-59)天；但无统计学意义。对比术后肝功能恢复情况,在术后第3天时,LH组的总胆红素为13.50±5.76μmol/L,明显低于OH组26.28±10.42μmol/L,P值为0.017,有统计学意义。LH组和OH组平均随访时间分别为31(6-45)个月,为23.6(7-40)个月,统计肿瘤复发以及长期生存曲线提示两者无明显统计学差异。结论腹腔镜肝切除在结直肠癌肝转移的治疗中,在术中出血、平均住院天数优于开腹肝切除组,但未发现有统计学意义,待大样本病例研究证实；在术后肝功能恢复情况中优于开腹肝切除,且有统计学意义,在肿瘤复发和长期生存率方面与开腹肝切除无明显差异。
[Abstract]:Objective to investigate the application of laparoscopy in the treatment of liver metastasis of colorectal cancer by retrospective analysis of liver metastases from colorectal cancer and cohort study of laparoscopic hepatectomy and open hepatectomy. Methods from January 1, 2011 to December 31, 2014, 20 patients with liver metastases from colorectal cancer were enrolled in the hospital of run run run Shaw Hospital, Zhejiang University Medical College. The operative time, intraoperative bleeding and blood transfusion rate, postoperative hospitalization days, postoperative liver function recovery, complications and long-term follow-up results were compared between laparoscopic hepatectomy group and open hepatectomy group. Results compared with the open hepatectomy group, the average operative time of the laparoscopic hepatectomy group was 247.22 ~ 50-360 minutes, which was slightly higher than that of the laparotomy group (205.63 ~ 110-360) minutes, and the amount of intraoperative bleeding was higher than that of the laparotomy group. The average postoperative hospitalization days in 305.0(50-800)ml and 693.8U 50-2000ml / L LH group were significantly less than those in OH group (10.2 卤5-23) days, which were significantly lower than those in open group (14.50 卤3-59) days, but there was no statistical significance. The total bilirubin in LH group was 13.50 卤5.76 渭 mol / L on the third day after operation, which was significantly lower than that in OH group (26.28 卤10.42 渭 mol / L P = 0.017). The mean follow-up time of LH group and OH group were 31g / 45 months and 23.67-40 months, respectively. Statistical analysis of tumor recurrence and long-term survival curve indicated that there was no significant difference between the two groups. Conclusion Laparoscopic hepatectomy in the treatment of liver metastasis of colorectal cancer, the average hospitalization days during operation is better than that in open hepatectomy group, but there is no statistical significance. The recovery of liver function after operation was better than that of open hepatectomy with statistical significance. There was no significant difference in tumor recurrence and long-term survival rate compared with open hepatectomy.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R735.34

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