腹腔镜辅助直肠癌根治术的临床疗效及卫生经济学评价

Clinical therapeutic effect and medical economics evaluation of laparoscopic assisted radical resection for rectal cancer

目的:评估腹腔镜辅助和开腹直肠癌根治术的短期疗效,并对卫生经济学做出评估。方法:50例直肠癌患者按自愿原则分为两组,开腹手术组和腹腔镜辅助手术组各25例,对比两组的手术时间、住院时间、出血量、术后排气时间、清除淋巴结数、并发症发生率和卫生经济学情况。结果:两组均顺利完成手术,手术时间、术中出血量、住院时间和肠功能恢复时间两组差异均有统计学意义(P<0.05),发生并发症的例数和淋巴结清扫数差异无统计学意义(P>0.05)。腹腔镜组手术费用多于开腹组(P<0.05),药物费用少于开腹组(P<0.05),住院总费用两组差异无统计学意义(P>0.05)。结论:腹腔镜辅助直肠癌根治术能取得微创手术的效果,其医疗总费用与开腹手术相比差异无统计学意义。

Objective：To study the short-term clinical effectiveness and medical economics of open rectectomy （OR） and laparoscopic-assisted rectal cancer radical resection （LAR） in the treatment of rectal cancer.Methods：The clinical data of fifty patients with rectal cancer were analyzed.25 of them received OR,while 25 of them received LAR according to their will.Besides cost,other outcomes measured included operative time,hospital stay,blood loss,time to pass flatus,number of harvesting lymph nodes and postoperative complications.Results：All operations were successfully performed.Compared with OR group,patients in the LAR group had significantly longer operative time,less length of hospital stay,blood loss and time to pass flatus （P0.05）.The difference of number of harvested lymph nodes and postoperative complications between 2 groups was not statistically significant （P0.05）.The patients in the LAR group had significantly more operation cost and less drug cost than OR group （P0.05）,but the total cost difference of the two groups was not statistically significant （P0.05）.Conclusions：Laparoscopic-assisted rectal cancer resection is mini-invasive,and its hospitalization cost is similar to open surgery.