腹腔镜一期切除结直肠癌及肝转移癌的临床观察
发布时间：2018-10-25 19:29
【摘要】：目的 对于结直肠癌伴肝转移(colorectal cancer with liver metastasis, CRCLM)病例,手术是其可能获得长期生存的确定性手段,但存在着分期手术、一期联合切除手术等争议,本研究重点评估腹腔镜结直肠癌切除后一期行腹腔镜或开放肝转移灶切除术方法的临床效果,探讨腹腔镜下结直肠癌伴肝转移同步切除的安全性及有效性。 方法 对2011年5月至2014年9月间于浙江大学医学院附属邵逸夫医院进行的20例腹腔镜同时切除结直肠癌及其肝转移灶手术(TL组)及16例腹腔镜结直肠癌切除后同期行开放肝转移灶切除术(AL组)患者的临床资料进行回顾性分析,主要分析指标包括：手术切除方式、手术时间、术中出血量、术后肛门排气恢复时间、术后腹腔引流管观察情况、术后住院天数、术后并发症等。 结果 全腔镜组在总腹腔引流管留置时间方面明显减少(P0.05)；两组术中出血量、手术时间、肛门排气时间、术后住院日数无统计学差异(P0.05)；两组患者均未出现严重术后并发症,无围手术期死亡病例,且术后生存率与传统开放手术无明显差异。 结论 结直肠癌肝转移施行腹腔镜一期切除安全可行。腹腔镜结直肠癌切除后同时行腹腔镜下或开放肝转移灶切除术方法,两者术中情况类似,但术后具有腹腔引流管留置时间段短的优势。
[Abstract]:Objective for (colorectal cancer with liver metastasis, CRCLM) patients with colorectal cancer with liver metastasis, surgery is a deterministic means of long-term survival, but there are controversies such as staging surgery, one-stage combined resection and so on. The aim of this study was to evaluate the clinical effect of laparoscopic or open liver metastases resection after laparoscopic colorectal cancer resection, and to explore the safety and efficacy of laparoscopic synchronous resection of colorectal cancer with liver metastasis. Methods from May 2011 to September 2014, 20 patients with colorectal cancer and their hepatic metastases (TL group) and 16 patients underwent laparoscopic resection of colorectal cancer (TL group), affiliated to run Shaw Hospital, Zhejiang University Medical College, and 16 cases of laparoscopic resection of colorectal cancer. The clinical data of patients undergoing open liver metastasis resection (AL group) were retrospectively analyzed. The main indicators included: surgical resection, operative time, blood loss, postoperative anal exhaust recovery time, postoperative observation of abdominal drainage tube, postoperative hospitalization days, postoperative complications, and so on. Results the total intraperitoneal drainage tube indwelling time was significantly decreased in the total laparoscopy group (P0.05), there was no significant difference between the two groups in intraoperative blood loss, operative time, anal exhaust time and postoperative hospitalization days (P0.05). There were no serious postoperative complications and no perioperative death in both groups, and there was no significant difference between the postoperative survival rate and the traditional open operation. Conclusion Laparoscopic one-stage resection of liver metastases from colorectal cancer is safe and feasible. Laparoscopic resection of colorectal cancer was performed at the same time by laparoscopic or open liver metastases. The two methods were similar in operation, but had the advantage of short time period of abdominal drainage tube after operation.
【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;R735.7
本文编号：2294609
[Abstract]:Objective for (colorectal cancer with liver metastasis, CRCLM) patients with colorectal cancer with liver metastasis, surgery is a deterministic means of long-term survival, but there are controversies such as staging surgery, one-stage combined resection and so on. The aim of this study was to evaluate the clinical effect of laparoscopic or open liver metastases resection after laparoscopic colorectal cancer resection, and to explore the safety and efficacy of laparoscopic synchronous resection of colorectal cancer with liver metastasis. Methods from May 2011 to September 2014, 20 patients with colorectal cancer and their hepatic metastases (TL group) and 16 patients underwent laparoscopic resection of colorectal cancer (TL group), affiliated to run Shaw Hospital, Zhejiang University Medical College, and 16 cases of laparoscopic resection of colorectal cancer. The clinical data of patients undergoing open liver metastasis resection (AL group) were retrospectively analyzed. The main indicators included: surgical resection, operative time, blood loss, postoperative anal exhaust recovery time, postoperative observation of abdominal drainage tube, postoperative hospitalization days, postoperative complications, and so on. Results the total intraperitoneal drainage tube indwelling time was significantly decreased in the total laparoscopy group (P0.05), there was no significant difference between the two groups in intraoperative blood loss, operative time, anal exhaust time and postoperative hospitalization days (P0.05). There were no serious postoperative complications and no perioperative death in both groups, and there was no significant difference between the postoperative survival rate and the traditional open operation. Conclusion Laparoscopic one-stage resection of liver metastases from colorectal cancer is safe and feasible. Laparoscopic resection of colorectal cancer was performed at the same time by laparoscopic or open liver metastases. The two methods were similar in operation, but had the advantage of short time period of abdominal drainage tube after operation.
【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;R735.7
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相关期刊论文 前2条
1 牟一平;杨鹏;严加费;陈其龙;袁晓明;朱玲华;徐晓武;;腹腔镜结肠癌根治术的临床疗效评估[J];中华外科杂志;2006年09期
2 刘荣,周宁新,黄志强;腹腔镜肝切除术的可行性[J];中国微创外科杂志;2005年01期
，本文编号：2294609
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