【摘要】：目的 對于結(jié)直腸癌伴肝轉(zhuǎn)移(colorectal cancer with liver metastasis, CRCLM)病例,手術(shù)是其可能獲得長期生存的確定性手段,但存在著分期手術(shù)、一期聯(lián)合切除手術(shù)等爭議,本研究重點(diǎn)評估腹腔鏡結(jié)直腸癌切除后一期行腹腔鏡或開放肝轉(zhuǎn)移灶切除術(shù)方法的臨床效果,探討腹腔鏡下結(jié)直腸癌伴肝轉(zhuǎn)移同步切除的安全性及有效性。 方法 對2011年5月至2014年9月間于浙江大學(xué)醫(yī)學(xué)院附屬邵逸夫醫(yī)院進(jìn)行的20例腹腔鏡同時(shí)切除結(jié)直腸癌及其肝轉(zhuǎn)移灶手術(shù)(TL組)及16例腹腔鏡結(jié)直腸癌切除后同期行開放肝轉(zhuǎn)移灶切除術(shù)(AL組)患者的臨床資料進(jìn)行回顧性分析,主要分析指標(biāo)包括：手術(shù)切除方式、手術(shù)時(shí)間、術(shù)中出血量、術(shù)后肛門排氣恢復(fù)時(shí)間、術(shù)后腹腔引流管觀察情況、術(shù)后住院天數(shù)、術(shù)后并發(fā)癥等。 結(jié)果 全腔鏡組在總腹腔引流管留置時(shí)間方面明顯減少(P0.05)；兩組術(shù)中出血量、手術(shù)時(shí)間、肛門排氣時(shí)間、術(shù)后住院日數(shù)無統(tǒng)計(jì)學(xué)差異(P0.05)；兩組患者均未出現(xiàn)嚴(yán)重術(shù)后并發(fā)癥,無圍手術(shù)期死亡病例,且術(shù)后生存率與傳統(tǒng)開放手術(shù)無明顯差異。 結(jié)論 結(jié)直腸癌肝轉(zhuǎn)移施行腹腔鏡一期切除安全可行。腹腔鏡結(jié)直腸癌切除后同時(shí)行腹腔鏡下或開放肝轉(zhuǎn)移灶切除術(shù)方法,兩者術(shù)中情況類似,但術(shù)后具有腹腔引流管留置時(shí)間段短的優(yōu)勢。
[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.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R735.34;R735.7

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