腹腔镜手术与传统手术切除治疗阑尾黏液性肿瘤疗效比较
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摘要
目的比较腹腔镜手术与传统手术切除治疗阑尾黏液性肿瘤的临床效果。方法回顾性分析北京市平谷区医院普外科2003年1月至2017年12月收治的行手术治疗的25例阑尾黏液性肿瘤患者的临床资料,根据患者所采用的手术方式分为传统开腹手术组11例和腹腔镜手术组14例,比较两组患者的手术时间、术中出血量、住院时间、疼痛评分、胃肠功能恢复时间、下床时间以及并发症发生情况。结果所有患者经手术治疗后均痊愈出院。腹腔镜手术组患者的手术时间为(159.56±50.35) min,略高于传统开腹手术组的(121.22±43.79) min,但差异无统计学意义(P>0.05);腹腔镜手术组和传统开腹手术组患者的术中出血量[(31.71±9.93) mL vs (60.78±18.44) mL]、住院时间[(5.31±1.23) d vs (7.83±2.06) d]、疼痛评分[(4.36±1.35)分vs (5.81±1.60)分]、胃肠功能恢复时间[(30.96±7.18) h vs (40.16±8.77) h]以及下床时间[(22.36±5.64) h vs (30.47±7.58) h]比较,腹腔镜手术组均明显少于传统开腹手术组,差异均具有统计学意义(P<0.05);腹腔镜手术组患者的并发症发生率为7.14%,明显低于传统开腹手术组的45.45%,差异具有统计学意义(P<0.05)。结论与传统开腹手术比较,腹腔镜手术治疗阑尾黏液性肿瘤具有创伤小、出血量少、住院时间短、疼痛少、恢复快以及并发症少等优势。
Objective To compare the clinical effects of laparoscopic surgery and traditional operation in the treatment of mucinous tumors of appendix. Methods The clinical data of 25 patients with appendiceal mucinous tumor treated in the Department of General Surgery at Beijing Pinggu Hospital from January 2003 to December 2017 were analyzed retrospectively. According to the operative methods, the patients were divided into traditional open surgery group(11 cases) and laparoscopic operation group(14 cases). The operative time, intraoperative bleeding volume, hospitalization time, pain score, gastrointestinal function recovery time, time of getting out of bed and complications were compared between the two groups. Results All patients were cured and discharged after operation. The operative time of the patients in the laparoscopic operation group was(159.56±50.35) min, which was slightly higher than that of(121.22±43.79) min in the traditional open surgery group, but the difference was not statistically significant(P>0.05). The intraoperative bleeding volume(31.71±9.93) mL vs(60.78±18.44) mL, hospitalization time(5.31±1.23) d vs(7.83±2.06) d, pain score(4.36±1.35) vs(5.81±1.60), gastrointestinal functional recovery time(30.96±7.18) h vs(40.16±8.77) h and the time of getting out of bed(22.36±5.64) h vs(30.47±7.58) h were significantly lower in the laparoscopic operation group than in the traditional open surgery group(P<0.05). The incidence of complications was 7.14% in the laparoscopic operation group, which was significantly lower than 45.45% in the traditional open surgery group(P<0.05). Conclusion Compared with the traditional open surgery, laparoscopic operation for appendix mucinous tumors has the advantages of less trauma, less bleeding volume, shorter hospital stay, less pain, faster recovery and fewer complications.
Objective To compare the clinical effects of laparoscopic surgery and traditional operation in the treatment of mucinous tumors of appendix. Methods The clinical data of 25 patients with appendiceal mucinous tumor treated in the Department of General Surgery at Beijing Pinggu Hospital from January 2003 to December 2017 were analyzed retrospectively. According to the operative methods, the patients were divided into traditional open surgery group(11 cases) and laparoscopic operation group(14 cases). The operative time, intraoperative bleeding volume, hospitalization time, pain score, gastrointestinal function recovery time, time of getting out of bed and complications were compared between the two groups. Results All patients were cured and discharged after operation. The operative time of the patients in the laparoscopic operation group was(159.56±50.35) min, which was slightly higher than that of(121.22±43.79) min in the traditional open surgery group, but the difference was not statistically significant(P>0.05). The intraoperative bleeding volume(31.71±9.93) mL vs(60.78±18.44) mL, hospitalization time(5.31±1.23) d vs(7.83±2.06) d, pain score(4.36±1.35) vs(5.81±1.60), gastrointestinal functional recovery time(30.96±7.18) h vs(40.16±8.77) h and the time of getting out of bed(22.36±5.64) h vs(30.47±7.58) h were significantly lower in the laparoscopic operation group than in the traditional open surgery group(P<0.05). The incidence of complications was 7.14% in the laparoscopic operation group, which was significantly lower than 45.45% in the traditional open surgery group(P<0.05). Conclusion Compared with the traditional open surgery, laparoscopic operation for appendix mucinous tumors has the advantages of less trauma, less bleeding volume, shorter hospital stay, less pain, faster recovery and fewer complications.
引文
[1]陈明,查云飞,王艳艳.阑尾黏液性囊腺瘤CT表现及文献复习[J].实用放射学杂志, 2016, 32(1):147-149.
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[10]但杰,王健,王永洪,等.腹腔镜阑尾切除术与开腹阑尾切除术的对比分析[J].实用医院临床杂志, 2016, 13(5):204-205.
[11]何毅,张鸿,何东生.腹腔镜根治术与传统开腹手术治疗结肠癌的临床效果对比分析[J].科技通报, 2017, 33(3):81-84.
[12]刘超,蒋国庆.腹腔镜手术治疗盆腔脓肿的临床疗效及手术时机的选择[J].临床和实验医学杂志, 2015,17(15):1294-1296.
[13]陈金水,张少炎,谭俊,等.腹腔游离节育环致绞窄性小肠坏死合并阑尾黏液性囊腺瘤1例[J].第二军医大学学报, 2017, 38(3):396-396.
[14]杨旭丹,王雷,王晓卿,等.原发性阑尾黏液性肿瘤46例临床病理分析[J].中华病理学杂志, 2016, 45(7):478-479.
[15]谭风波,刘合利,喻南慧,等.原发性阑尾黏液腺癌30例诊治分析[J].中华胃肠外科杂志, 2017, 20(3):340-341.
[16]戴永美,刘夏平,马千里,等.阑尾肿瘤临床诊疗分析[J].中华实用诊断与治疗杂志, 2016, 30(8):831-832.
[2]王栋华,杜联芳,陈红燕,等.阑尾黏液性肿瘤的临床与超声表现及良恶性鉴别[J].中国超声医学杂志, 2016, 32(6):563-565.
[3]孔德建.开腹和腹腔镜手术治疗儿童急性阑尾炎疗效比较[J].海南医学, 2013, 24(11):1602-1604.
[4]孙光,彭勃,宋文渊.腹腔镜联合手术治疗肠黏连合并阑尾炎22例临床分析[J].海南医学, 2012, 23(17):59-60.
[5]沈亮,胡湘,李浪平,等. PainVision法与视觉模拟评分评估腹腔镜疝修补术术后疼痛程度的相关性[J].上海医学, 2016, 39(6):336-339.
[6]马越,涂水平.原发性阑尾黏液性肿瘤的临床特点和生存分析[J].胃肠病学, 2016, 21(11):662-667.
[7]徐达峰,马周鹏,谢一平,等.阑尾黏液性肿瘤的CT表现及临床分析[J].中国医师进修杂志, 2016, 39(9):846-849.
[8]陈瑞云,张琳,孙国锋,等.腹腔镜手术治疗阑尾黏液性肿瘤的临床体会(附11例报告)[J].腹腔镜外科杂志, 2017, 22(8):612-614.
[9]张梅,高凤娟,孟凡青,等.阑尾黏液性肿瘤病理学特征及预后分析[J].中华胃肠外科杂志, 2014, 17(1):65-70.
[10]但杰,王健,王永洪,等.腹腔镜阑尾切除术与开腹阑尾切除术的对比分析[J].实用医院临床杂志, 2016, 13(5):204-205.
[11]何毅,张鸿,何东生.腹腔镜根治术与传统开腹手术治疗结肠癌的临床效果对比分析[J].科技通报, 2017, 33(3):81-84.
[12]刘超,蒋国庆.腹腔镜手术治疗盆腔脓肿的临床疗效及手术时机的选择[J].临床和实验医学杂志, 2015,17(15):1294-1296.
[13]陈金水,张少炎,谭俊,等.腹腔游离节育环致绞窄性小肠坏死合并阑尾黏液性囊腺瘤1例[J].第二军医大学学报, 2017, 38(3):396-396.
[14]杨旭丹,王雷,王晓卿,等.原发性阑尾黏液性肿瘤46例临床病理分析[J].中华病理学杂志, 2016, 45(7):478-479.
[15]谭风波,刘合利,喻南慧,等.原发性阑尾黏液腺癌30例诊治分析[J].中华胃肠外科杂志, 2017, 20(3):340-341.
[16]戴永美,刘夏平,马千里,等.阑尾肿瘤临床诊疗分析[J].中华实用诊断与治疗杂志, 2016, 30(8):831-832.