腹腔镜和开腹结直肠癌根治术对胃肠功能的影响(1)
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[摘要] 目的 对比研究腹腔镜和开腹结直肠癌根治术的疗效及二者对胃肠功能的影响。 方法 将经病理活检确诊的56例结肠癌患者随机分为腹腔镜组和开腹组各28例，比较两组手术时间、术中出血量、胃肠功能恢复情况及术中术后并发症、随访后局部复发及远处转移情况。 结果 腹腔镜组手术时间长，但与对照组比较，腹腔镜组的术中出血量少，术中需要输血患者少且术后应用吗啡用量明显少于对照组，腹腔镜组患者术后的肠鸣音恢复快、排气时间快、进食时间快、住院时间短，两组比较差异有统计学意义(P < 0.01)。腹腔镜手术对胃肠的干扰较开腹手术少，术后肠蠕动恢复快。对两组的术中术后并发症比较显示，腹腔镜的并发症明显少于对照组，差异有统计学意义(P < 0.01)。3～12个月的随访显示，腹腔镜组未发现切口种植，局部复发2例，远处转移1例；开腹组局部复发2例，远处转移2例，两组间差异无统计学意义。 结论 与传统开腹结直肠癌根治术相比，腹腔镜结直肠癌根治术具有出血少、并发症少、住院时间短等优点，且能促进患者胃肠功能的尽快恢复，值得临床推广和应用。
[关键词] 腹腔镜结直肠癌根治术；开腹结直肠癌根治术；胃肠功能；并发症
[中图分类号] R735.3 [文献标识码] B [文章编号] 1673-9701(2012)06-0034-02
The impact of laparoscopic and open resection on gastrointestinal function in patients with colorectal cancer
WEI Feng
Department of General Surgery, the Central Hospital of Huzhou City in Zhejiang Province, Huzhou 313000, China
[Abstract] Objective To compare the efficacy of laparoscopic and open resections and their impact on gastrointestinal function in patients with colorectal cancer. Methods The biopsy diagnosis of 56 cases of colon cancer were randomly divided into two groups of laparoscopic group and open group with 28 cases in each, two groups were compared. Results Laparoscopic surgery last for a longer time, but compared with the control group, laparoscopic surgery had less blood loss, less intraoperative need for blood transfusion, less postoperative morphine consumption, faster recovery of bowel sounds, faster flatus, earlier eating time, shorter hospital stay, and the differences of the two groups were statistically significant (P < 0.01). The laparoscopic surgery had less gastrointestinal disturbance and quicker recovery after bowel movements than those of open surgery. Comparison of postoperative complications in the two groups showed that laparoscopic complications was significantly less and the difference was statistically significant (P < 0.01). Two groups of patients 3-12 months of follow-up showed that laparoscopic group did not found incision plantation, two cases of local recurrence, distant metastasis in 1 case, laparotomy group 2 cases of local recurrence, distant metastasis in 2 cases, between the two groups there was no significant difference ......
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