【摘要】：目的:以我院開腹完成完整結(jié)腸系膜切除術(shù)(CME)患者的臨床資料為標(biāo)準(zhǔn),來說明腹腔鏡完成該手術(shù)的近期臨床效果。方法:本研究所選取的病例來源于我院普通外科,病例收集的時間從2012年1月開始,截止日期為2017年2月。嚴(yán)格按照納入標(biāo)準(zhǔn)和排除標(biāo)準(zhǔn),共收集到85例患者的病歷資料。將納入研究的結(jié)腸癌患者根據(jù)實施手術(shù)的方法分別研究,分為左半結(jié)腸癌CME和右半結(jié)腸癌CME。左半結(jié)腸癌組行腹腔鏡左半結(jié)腸癌CME21例,開腹為34例。右半結(jié)腸癌組行腹腔鏡結(jié)腸癌CME14例,開腹16例。在左半和右半結(jié)腸癌CME中分別比較腹腔鏡和開腹兩種術(shù)式在淋巴結(jié)清掃效果等方面的異同。結(jié)果:無論是在左半結(jié)腸癌CME還是在右半結(jié)腸癌CME手術(shù)組,腹腔鏡完成該手術(shù)和開腹完成該手術(shù)后,清掃淋巴結(jié)的效果基本相當(dāng),術(shù)后并發(fā)癥的發(fā)生率基本相同,在這些指標(biāo)方面的差異無統(tǒng)計學(xué)意義(P0.05)。無論是在左半結(jié)腸癌CME還是在右半結(jié)腸癌CME組,腹腔鏡完成該手術(shù)和開腹完成該手術(shù),腹腔鏡手術(shù)后胃腸功能的恢復(fù)相對較快,但在本研究中腹腔鏡完成該手術(shù)的時間相對較長(P0.05)。手術(shù)出血量方面,在左半結(jié)腸癌CME中,腹腔鏡手術(shù)出血量少(P0.05),在右半結(jié)腸癌CME中,腹腔鏡和開腹完成該手術(shù)的效果相當(dāng)(P0.05)。結(jié)論:在安全性方面(清掃淋巴結(jié)效果和術(shù)后并發(fā)癥),腹腔鏡和開腹完成該手術(shù)的效果相當(dāng)。諸多方面的原因,本研究中腹腔鏡完成該手術(shù)的時間相對較長,但胃腸功能的恢復(fù)方面,腹腔鏡完成該手術(shù)的效果較好。手術(shù)出血量方面,在左半結(jié)腸癌CME中,腹腔鏡手術(shù)出血量少,在右半結(jié)腸癌CME中,腹腔鏡和開腹手術(shù)的效果相當(dāng)。
[Abstract]:Objective: to evaluate the clinical effect of laparoscopy in patients with complete mesorectal resection (CME) according to the clinical data of patients undergoing complete laparoscopic surgery in our hospital. Methods: the selected cases were from general surgery in our hospital. The time of case collection began in January 2012 and the deadline was February 2017. A total of 85 patients were collected according to the inclusion criteria and exclusion criteria. Patients with colon cancer included in the study were divided into left colon cancer CME and right colon cancer CME according to the operative method. Left colon cancer group was treated with laparoscopic left colon cancer (CME21), 34 cases were open. In the right hemicolon group, laparoscopic colon cancer CME14 was performed in 16 patients. The results of lymph node dissection were compared between laparoscopy and laparotomy in CME of left and right colon cancer respectively. Results: whether in the left colon cancer CME group or the right colon cancer CME operation group, the effect of lymph node dissection was basically the same, and the incidence of postoperative complications was basically the same after laparoscopy and laparotomy. There was no significant difference in these indexes (P0.05). Whether in the left colon cancer CME group or the right colon cancer CME group, laparoscopy performed the operation and the laparotomy performed the operation, and the gastrointestinal function recovered relatively quickly after laparoscopic surgery. But in this study, laparoscopic surgery was completed relatively long time (P0.05). In the aspect of blood loss, in CME of left colon cancer, the amount of bleeding in laparoscopic surgery was less (P0.05), in CME of right colon cancer, the effect of laparoscopy and laparotomy was similar (P0.05). Conclusion: in terms of safety (lymph node dissection and postoperative complications), laparoscopy and laparotomy are equally effective. In this study, the laparoscopic operation took a long time to complete, but the recovery of gastrointestinal function was better. In the aspect of operative bleeding, laparoscopic surgery has less bleeding in CME of left colon cancer, and in CME of right colon cancer, the effect of laparoscopy and open surgery is equal.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R735.35

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