【摘要】 目的分析腹腔镜结直肠癌手术与开腹手术后并发症的风险因素。方法将收治的344例结直肠癌患者分为腹腔镜手术组(n=170)和开腹手术组(n=174)。入院时对患者的临床一般资料进行统计,同时也对2组手术后的并发症风险因素进行分析。结果手术后并发症的总发病率为26.5%,其中腹腔镜组为18.8%,明显少于开腹组33.9%(P<0.01)。腹腔镜组大肠功能恢复快,且住院时间短。整宗病例的多因素分析发现手术时间、输血是手术后并发症的风险因素。开腹组失血、输血、手术时间、体质量减轻、年龄等与手术后并发症有关;腹腔镜组的风险因素仅仅与手术时间有关。结论腹腔镜手术可避免年龄、输血、失血量等多种风险因素。更多还原

【Abstract】 Objective To evaluate whether laparoscopic colorectal surgery can reduce the risk factors that contribute to postoperative morbidity. Methods A total of 344 consecutive patients with colorectal diseases were randomized to laparoscopic surgery (n=170) or open operation (n=174). On admission, the demographics, comorbidity, and nutritional status were recorded. Operation variables, patient outcome, and length of stay were also recorded. Postoperative complications were registered by four members of staff not involved in the study. Results The overall morbidity rate was 26.5%, and the rate in the laparoscopic group (18.8%) was significantly lower than that in the open group (33.9%; P<0.01). The patients in the laparoscopic group had a faster recovery of bowel function (P<0.01) and a shorter length of stay (P<0.01). In the whole cohort of patients, multivariate analysis identified open operation, duration of operation, and blood transfusion as risk factors for postoperative morbidity. In the open group, blood loss, blood transfusion, duration of operation, weight loss, and age were related to postoperative morbidity. In the laparoscopic group the only risk factor identified was duration of operation. Conclusion Most risk factors for postoperative morbidity in open operation group are not risk factors any more in the laparoscopic group, especially postoperative morbidity and length of stay are significantly reduced.更多还原