直接手助腹腔镜与开腹直肠癌根治的疗效比较

Clinical comparison between hand-assisted laparoscopy and open radical resection in the treatment of rectal cancer

目的:探讨应用直接手助腹腔镜下直肠癌根治的可行性及近期临床疗效.方法:将我院2005-01/2007-01同期收治的直肠癌患者分为腹腔镜和传统开腹组各31例进行相应手术,对其临床资料进行回顾性分析.结果:腹腔镜组无1例中转开腹.腹腔镜组与开腹组相比,术中平均出血量(150±42.5 mL vs 250±34.6 mL,P<0.05)、肠道功能恢复时间(2±1.0 d vs 4±1.0 d,P<0.05)、术后并发症发生率(3.2% vs 12.9%,P<0.05)均有显著差异,而手术时间、局部复发率及在淋巴结清扫范围方面无显著差异(P>0.05).结论:直接手助腹腔镜治疗直肠癌能取得与开腹手术同样的肿瘤根治性效果,并具有出血少、术后肠功能恢复快等优点.

AIM： To evaluate the feasibility and shortterm efficacy of hand-assisted laparoscopy and open radical resection in the treatment of rectal cancer. METHODS： From January 2005 to January 2007, hand-assisted laparoscopic surgery （HALS） and open radical resection （ORR） were performed in 31 cases of rectal cancer, respectively. The curative effect and clinical data were collected and retrospectively analyzed. RESULTS： No cases were converted to open surgery after HALS. The mean blood loss （150 ± 42.5 mL vs 250 ± 34.6 mL, P 〈 0.05）, restoration time of intestinal function （2 ± 1.0 d vs 4 ± 1.0 d, P 〈 0.05） and post-operative complication rate （3.2% vs 12.9%, P 〈 0.05） were significantly different between HALS and ORR group. However, the operation time, local recurrence rate and lymph node harvest had no marked difference between the two groups. CONCLUSION： Both HALS and ORR are feasible and safe for the patients with rectal cancer, but the former can provide a better bowel function restoration and less blood loss.