本文選題：腹腔鏡肝切除 + 開腹肝切除��； 參考：《浙江大學(xué)》2015年碩士論文

【摘要】：目的通過回顧性分析結(jié)直腸癌肝轉(zhuǎn)移病例,對(duì)比腹腔鏡肝切除和開腹肝切除的隊(duì)列研究,探究腹腔鏡在治療結(jié)直腸癌肝轉(zhuǎn)移中的應(yīng)用。 方法統(tǒng)計(jì)2011年1月1日至2014年12月31日期間于浙江大學(xué)醫(yī)學(xué)院附屬邵逸夫醫(yī)院住院院治療的結(jié)直腸癌肝轉(zhuǎn)移病例20例。比較腹腔鏡肝切除和開腹肝切除組的手術(shù)時(shí)間,術(shù)中出血及輸血率,術(shù)后住院天數(shù)術(shù),后肝功能恢復(fù),并發(fā)癥和長期隨訪結(jié)果。 結(jié)果與開腹肝切除(OH)組相比,腹腔鏡肝切除(LH)組平均手術(shù)時(shí)間247.22(50-360)分鐘,略高于開腹組的205.63(110-360)分鐘；而術(shù)中出血量,兩組分別為305.0(50-800)ml和693.8(50-2000)ml,LH組出血明顯少于OH組；LH組術(shù)后平均住院天數(shù)為10.2(5-23)天,明顯小于開腹組的14.50(3-59)天；但無統(tǒng)計(jì)學(xué)意義。對(duì)比術(shù)后肝功能恢復(fù)情況,在術(shù)后第3天時(shí),LH組的總膽紅素為13.50±5.76μmol/L,明顯低于OH組26.28±10.42μmol/L,P值為0.017,有統(tǒng)計(jì)學(xué)意義。LH組和OH組平均隨訪時(shí)間分別為31(6-45)個(gè)月,為23.6(7-40)個(gè)月,統(tǒng)計(jì)腫瘤復(fù)發(fā)以及長期生存曲線提示兩者無明顯統(tǒng)計(jì)學(xué)差異。 結(jié)論腹腔鏡肝切除在結(jié)直腸癌肝轉(zhuǎn)移的治療中,在術(shù)中出血、平均住院天數(shù)優(yōu)于開腹肝切除組,但未發(fā)現(xiàn)有統(tǒng)計(jì)學(xué)意義,待大樣本病例研究證實(shí)；在術(shù)后肝功能恢復(fù)情況中優(yōu)于開腹肝切除,且有統(tǒng)計(jì)學(xué)意義,在腫瘤復(fù)發(fā)和長期生存率方面與開腹肝切除無明顯差異。
[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 鹵5-23) days, which were significantly lower than those in open group (14.50 鹵3-59) days, but there was no statistical significance. The total bilirubin in LH group was 13.50 鹵5.76 渭 mol / L on the third day after operation, which was significantly lower than that in OH group (26.28 鹵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.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R735.34

【參考文獻(xiàn)】

相關(guān)期刊論文 前3條

1 Evangelos P Misiakos;Nikolaos P Karidis;Gregory Kouraklis;;Current treatment for colorectal liver metastases[J];World Journal of Gastroenterology;2011年36期

2 Shan Ke;Xue-Mei Ding;Xiao-Jun Qian;Yi-Ming Zhou;Bao-Xin Cao;Kun Gao;Wen-Bing Sun;;Radiofrequency ablation of hepatocellular carcinoma sized> 3 and ≤ 5 cm: Is ablative margin of more than 1 cm justified?[J];World Journal of Gastroenterology;2013年42期

3 Khurum Khan;Anita Wale;Gina Brown;Ian Chau;;Colorectal cancer with liver metastases:Neoadjuvant chemotherapy,surgical resection first or palliation alone?[J];World Journal of Gastroenterology;2014年35期

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本文編號(hào)：1846087