腹腔镜与开腹直肠癌腹会阴联合切除术近期结果对比分析

Analysis of the short-term outcomes after laparoscopic and open abdominoperineal resection of rectal cancer

目的探讨腹腔镜下直肠癌腹会阴联合切除术的可靠性及安全性。方法回顾性分析96例直肠癌腹会阴联合切除病例的临床资料,其中腹腔镜手术42例,同期开腹手术病例54例,对比分析腹腔镜与开腹直肠癌腹会阴联合切除术的近期效果。结果腹腔镜组与开腹组所有手术均达到肿瘤根治性切除标准。腹腔镜组与开腹组平均淋巴结清扫数目分别为14.6个和12.3个,术中出血量腹腔镜组少于开腹组,分别为382.0ml和519.4ml;术后排气时间、进食时间及术后患者下床时间腹腔镜组均较开腹组提前,且差异有统计学意义;腹腔镜组与开腹组并发症发生率分别为11.9%和16.7%,无统计学差异。结论腹腔镜直肠癌腹会阴联合切除术是安全可行的,且具有出血少、胃肠功能恢复快、并发症发生率低及术后住院时间短等优势。

Objective To investigate the feasibility and safety of laparoscopic abdominoperineal resection of rectal cancer. Methods Clinical data of 96 patients with rectal cancer who received abdominoperineal resection were reviewed retrospectively. Forty-two of these patients received laparoscopic operation and 54 cases received open resection. The short-term outcomes of laparoscopic abdominoperineal resection and open resection of rectal cancer were compared. Results All resections in the two groups achieved radical excision. The average number of removed lymph nodes in laparoscopic group （ LAG） and open group （ OG） was 14. 6 and 12. 3,respectively. The blood loss was 382. 0 ml in LAG and 519. 4 ml in OG. Passing flatus,food intake and out-of-bed activity were earlier in LAG compared with patients in OG,and differences were statistically significant. The incidence of complication in LAG and OG was similar. Conclusions Laparoscopic abdominoperineal resection is safe and feasible for the patient with rectal cancer,with less complications and blood loss,more rapid intestinal recovery and shorter time of hospital stay compared with open surgery.