腹腔镜下直肠癌根治术无瘤技术效果观察

Therapeutic Efficacy of Laparoscopic Radical Resection with Tumor-free Technique of Rectal Carcinoma

通过对比分析腹腔镜下直肠癌根治术与开腹直肠癌根治术中的无瘤技术，探讨腹腔镜下直肠癌根治术中无瘤技术的可行性及临床效果。将2004年5月至2006年1月80例直肠癌患者随机分为开腹组和腹腔镜组，开腹组40例，腹腔镜组40例。两组在年龄、性别、肿瘤分期方面差异无统计学意义。对比两组患者的术中淋巴结清扫数目、切除标本系膜完整性、切缘阴性率、腹腔冲洗液及吻合口复发率、远处转移率、切口种植率等。结果显示，两组在淋巴结清扫数目、切除标本系膜完整性、切缘阴性率、腹腔冲洗液及吻合口复发率、远处转移率、切口种植率比较差异无统计学意义（P〉0．05）。结果表明，腹腔镜下直肠癌根治术遵循无瘤技术操作是安全的手术。

The obje radical resection ctive of this study is to discuss the feasiblity and therapeutic efficacy of laparoscopic comparing with open radical resection. Eighty patients with rectal carcinoma were evenly randomized into two groups and underwent laparoscopie radical resection（40 cases, the peritoneoscopic group） and underwent open abdominal radical resection（ 40 cases, the open abdominal group）respectively from May 2004 to January 2006. There was no statistical difference in age, sex and tumor staging between the two groups. The following indexes of the two groups were recorded and compared： number of lymph nodes clearance, the intact status of the mesorectum, negative rate of the margin,positive rate of tumor cells in the abdominal flushing fluid,recurrence rate of the anastomotic stoma,distal metastasis rate and the rate of implantation at ineisional wound. As results,there was no statistical significance in the above indexes between the two groups（ P 〉0.05）. It is concluded that laparoscopic radical resection of rectal carcinoma done in line with tumor-free manipulation is safe.