低位直肠癌腹腔镜与开腹根治术的疗效比较

Comparison between the clinical efficacies of laparoscopic radical resection and open radical resection for 101 patients with low rectal cancer

目的:比较低位直肠癌腹腔镜与开腹根治术的临床疗效。方法:回顾分析广东省人民医院2006年6月至2008年12月收治的101例低位直肠癌患者的临床资料。结果:根据随机数字表进行分组,52例接受腹腔镜手术,49例接受传统开腹手术。腹腔镜手术组中2例(3.8%)中转开腹手术。腹腔镜手术组术中出血量为(90±40)mL,明显少于开腹手术组的(270±140)mL(P=0.023)。腹腔镜手术组48h肛门排气的患者占46.2%(24/52),明显高于开腹手术组的18.4%(9/49)(P=0.003)。开腹手术组需要使用止痛药止痛的患者占55.1%(27/49),明显高于腹腔镜手术组的17.3%(9/52)(P=0.000)。腹腔镜手术组平均总住院时间为(8.7±5.5)d,明显短于开腹手术组(12.5±7.3)d(P=0.028)。两组其他临床病理因素(性别、年龄、收获淋巴结的数目、TNM分期和术后并发症的发生率)的差异无统计学意义(P>0.05)。结论:腹腔镜低位直肠癌根治术较开腹手术具有术中出血少、术后痛苦少和恢复快等优点,同时能达到根治的要求。

Objective To evaluate the clinical efficacies of laparoscopic radical resection and open radical resection for low rectal cancers.Methods Clinical data of 101 patients with low rectal cancers treated by laparoscopic radical resection（n = 52） or open radical resection（n = 49） from June 2006 to December 2008 were analyzed retrospectively.Results Two patients（3.8%） in the laparoscopic surgery group were converted to open surgery.The average intraoperative blood loss in laparoscopic surgery group was significantly less than that in open surgery group [（90 ± 40） mL vs.（270 ± 140） mL,P = 0.023].There were 24 and 9 patients with the intestinal function restored within 48 hours after surgery in laparoscopic surgery group and open surgery group,respectively（P = 0.003）,and were 9 and 27 patients needed analgesic drugs（P = 0.000）.The average hospital stay was shorter in laparoscopic surgery group than that in open surgery group [（8.7 ± 5.5）d vs.（12.5±7.3）d,P = 0.028）.No significant difference was found between the two groups in gender,age,lymph node harvest,TNM staging,and postoperative complications（P 0.05）.Conclusion As compared with open radical resection,the laparoscopic radical resection for low rectal cancer is associated with less intraoperative blood loss,shorter length of hospital stay,and enhanced recovery.