腹腔镜全直肠系膜切除术治疗低位直肠癌疗效观察

Effect of laparoscopic total mesorectal excision for low rectal cancer

目的探讨腹腔镜全直肠系膜切除术(TME)治疗低位直肠癌的疗效。方法 35例低位直肠癌患者根据治疗方法不同分为开腹TME组20例和腹腔镜TME组15例,观察比较2组患者术中出血量、清除淋巴结数目、手术时间、胃肠功能恢复时间、拔出导尿管时间及术后并发症发生情况。结果腹腔镜TME组患者术中出血量明显少于开腹TME组(P<0.05),肛门排气时间和拔出导尿管时间明显短于开腹TME组(P<0.05);但2组清除淋巴结数目及手术时间比较差别无统计学意义(P>0.05)。腹腔镜TME组术后并发症发生率明显低于开腹TME组(P<0.05)。结论腹腔镜TME治疗低位直肠癌安全可行,近期疗效与开腹TME相当;且创伤小,术中出血量少,胃肠功能恢复快,并发症少。

Objective To study the effect of laparoscopic total mesorectal excision（TME） for low rectal cancer. Methods Thirty-five patients with low rectal cancer were divided into the open TME group（n=20） and laparoscopic TME group（n=15） according to operative method.The operative blood losses,number of lymph node harvest,operation time,gastrointestinal functional restoration time,catheter extraction time and postoperative complications were observed and compared between two groups. Results Compared with the open TME group,the operative blood losses were fewer（P0.05）,the time of passage of gas by anus and catheter extraction time were shorter in laparoscopic TME group（P0.05）.There was no statistical difference in the number of lymph node harvest and operation time between two groups（P0.05）.The rate of postoperative complications was lower in laparoscopic TME group than that in open TME group（P0.05）. Conclusion Laparoscopic TME for low rectal cancer was safe and feasible,which provides better short-term outcomes compared with open TME.It has the characteristic of minor wound,less blood loss,faster recovery of gastrointestinal function and less complications.