中国实用外科杂志

中国实用外科杂志

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腹腔镜与开腹手术治疗浆膜浸润结直肠癌预后对比研究

刘    峰，余    江，梁耀泽，胡彦锋，王亚楠，李国新   

  1. 南方医科大学附属南方医院普外科，广东广州 510515
  • 发布日期:2011-12-29

  • Published:2011-12-29

摘要：

目的    评价腹腔镜及开腹手术治疗浆膜浸润结直肠癌病人的预后。方法    回顾性分析2003年6月至2007年6月南方医科大学附属南方医院收治的浆膜浸润结直肠癌病人的临床、病理资料及随访数据。对两组病人生存及复发情况进行比较。结果    腹腔镜组和开腹组病人的基线数据及随访时间差异无统计学意义。腹腔镜组总死亡率为20.7%，开腹组为28.9%，两组之间差异无统计学意义（P=0.234）；腹腔镜组肿瘤相关死亡率为17.2%，开腹组为26.8%，两组之间差异无统计学意义（P=0.105）；腹腔镜组复发率为12.1%，开腹组为26.8%，差异有统计学意义（P=0.024）。生存分析显示腹腔镜组病人累积无复发率高于开腹组（P=0.035），两组病人累积总存活率（P=0.159）及肿瘤相关存活率（P=0.083）差异无统计学意义。结论    对于浆膜侵润的结直肠癌，腹腔镜组病人复发率明显低于开腹组，因此可以获得部分优于开腹手术的结果。

关键词: 浆膜浸润结直肠癌, 腹腔镜手术, 开腹手术, 预后

Abstract:

Laparoscopic versus open surgery in treating serosa-invaded colorectal cancer: a comparative study of prognosis        LIU Feng, YU Jiang, LIANG Yao-ze, et al. Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
Corresponding author:LI Guo-xin, E-mail:gzliguoxin@163.com
Abstract    Objective    To evaluate the prognosis between laparoscopic and open approach in treatment of serosa-invaded colorectal cancer. Methods    The clinicopathological and follow-up data of patients with serosa-invaded colorectal cancer in the Nan fang Hospital of Southern Medical University from Jun. 2003 to Jun. 2007 were analyzed retrospectively. Recurrence and survival rates were compared respectively between two groups. Results There were no statistically significant differences of baseline data and follow up period between laparoscopic surgery (LS) and open surgery (OS) groups. No significant differences were observed in overall mortality (20.7 % in LS and 28.9 % in OS, P= 0.234) and cancer-related mortality (17.2% in LS and 26.8 % in OS, P =0.105). The difference of recurrence rate (12.1 % in LS and 26.8 % in OS, P= 0.024) between the two groups was significant. As survival analysis showed, there were no significant differences in cumulative overall survival(P=0.159) and cumulative cancer-related survival(P=0.083). The difference of recurrence-free rates between the two groups was  significant(P=0.024). Conclusion    The recurrence rate of LS was fewer obviously than OS, so the laparoscopic surgery can obtain some superior outcomes compared with open surgery for serosa-invaded colorectal cancer.

Key words: serosa-invaded colorectal cancer, laparoscopic surgery, open surgery, prognosis