腹腔镜与开腹二期肝切除治疗结直肠癌肝转移的短期疗效比较

【摘要】 目的 探讨腹腔镜肝切除与开腹肝切除对结直肠癌肝转移的短期疗效。方法 自2008年1月至2012年12月,对94例结直肠癌肝转移患者行二期肝切除,其中腹腔镜手术46例,开腹手术48例,收集并比较两组患者的短期疗效资料。所有患者中,左半肝切除35例,右半肝切除28例,不规则楔形切除术31例;原发结直肠癌切除后3~6个月再次采取手术进行肝内病灶切除。 结果 腹腔镜肝切除的结直肠癌肝转移患者术中出血量较开腹组明显减少(P<0.05),住院时间显著缩短(P<0.05),且具有较低的术后谷丙转氨酶、谷草转氨酶、胆红素及白细胞水平(P<0.05)。两组并发症发生率差异无统计学意义。 结论 对于结直肠癌肝转移二期肝切除患者,腹腔镜手术安全可靠,术后短期疗效较开腹好。

Comparison of short-term curative effect between laparoscopic and open secondary hepatectomy in the treatment of liver metastasis of colorectal cancer

Objective To investigate the short-term effect between laparoscopic hepatectomy resection and open hepatectomy for liver metastasis of colorectal cancer. Methods From January 2008 to December 2012, 94 cases with liver metastasis of colorectal cancer underwent secondary hepatectomy,including laparoseopic operation in 46 cases, open abdominal operation in 48 cases. Among 94 cases, 35 were underwent left hemihepatectomy, 28 right hemihepateetomy, and 31 irregular wedge resection of liver. The resection of hepatic metastatic lesions were performed in three to six months after primary colorectal cancer resection. The short-term clinical efficacies were compared between two groups. Results Compared with open abdominal operation, laparoseopic hepatectomy had less intraoperative bleeding, shorter hospitalization time and lower levels of postoperative alanine transaminase, aspartate transaminase, bilirubin and leukocyte count （P 〈0.05）. Conclusion For patients with hepatic metastases of eolorectal eaneer, secondary hepatectomy laparoscopic operation is safe and reliable, and has better short-term effect than open opertion.