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目的:比较腹腔镜下全结肠切除术和传统开腹术在治疗家族性息肉病的安全性与有效性。方法:回顾性分析2003年1月—2011年1月间收治的家族性息肉病患者56例的临床资料,按术式将患者分为腹腔镜组(31例)和传统开腹组(25例),比较两组术前、术中及术后情况。结果:两组术前一般资料具有可比性(P>0.05);两组术中失血量无明显差异,均无输血(均P>0.05),腹腔镜组平均手术时间长于开腹组(330 min vs.160 min)(P<0.05);术后,两组除胃肠道恢复时间无统计学差异外(P>0.05),与开腹组比较,腹腔镜组术后并发症发生率(0 vs.24%),止痛药使用例数(0 vs.6),平均住院时间(8 d vs.14 d)及术后前3天平均引流量(30 mL vs.100 mL)均明显减少(均P<0.05);术后3个月,腹腔镜组未见复发,而开腹组3例复发(P<0.05)。结论:腹腔镜下全结肠切除术可以安全有效地治疗家族性息肉病,且较开腹术在生活质量和远期疗效方面存在优势。
Objective: To compare the safety and efficacy of laparoscopic total colon resection and traditional open surgery in the treatment of familial polyposis. Methods: The clinical data of 56 patients with familial polyposis admitted from January 2003 to January 2011 were retrospectively analyzed. According to the operation, the patients were divided into laparoscopic group (31 cases) and traditional laparotomy group (25 cases ), Compared the two groups preoperative, intraoperative and postoperative conditions. Results: The general data of two groups were comparable (P> 0.05). There was no significant difference in blood loss between the two groups (all P> 0.05). The mean operative time in laparoscopic group was longer than that in open group (P <0.05). There was no significant difference in the recovery time of gastrointestinal tract between the two groups after operation (P> 0.05). Compared with the open group, the incidence of postoperative complications (0 vs.24%), the number of painkillers used (0 vs.6), the average length of stay (8 d vs 14 days) and the average drainage volume in the first 3 days (30 mL vs.100 mL) P <0.05). No recurrence was found in the laparoscopic group at 3 months after operation, and 3 cases in the laparotomy group were recurrence (P <0.05). CONCLUSIONS: Laparoscopic total colectomy can safely and effectively treat familial polyposis and is superior to open surgery in terms of quality of life and long-term efficacy.