腹腔镜和开腹手术治疗低位直肠癌对比研究

Laparoscopic surgery versus open surgery for low colorectal cancer

目的:探讨腹腔镜术治疗低位直肠癌可行性和临床疗效。方法:回顾性分析2005年4月～2011年1月在我院确证为低位直肠癌行术134例患者的临床资料,其中腹腔镜组58例,遵循全肠系膜切除原则行腹腔镜低位直肠癌术;开腹手术组76例,行常规开腹手术。通过比较两组患者手术时间、术中出血量、淋巴结清扫状况、术后肠功能恢复情况、术后住院时间、并发症、住院费用等情况评价两种手术的临床疗效。结果:腹腔镜组的术中出血量、肠功能恢复时间和住院天数均明显少于开腹组,同时并发症发生率也均少于开腹组,但其手术时间较长,两组差异显著(P<0.05);此外腹腔镜组切除淋巴结数、局部复发率和远处转移率与开腹组无显著差异(P>0.05)。结论:腹腔镜术疗直肠癌效果很好,具有创伤小、康复快等优点,优于开腹术,值得临床推广应用。

Objective： To explore the clinical effects and feasibility of laparoscopic surgery for low colorectal cancer. Methods. Data of 134 patients with low rectal cancer admitted to our hospital during A- pril 2005 and January 2011 were retrospectively analyzed, of which 58 cases underwent laparoscopic sur- gery and had full mesenteric resection, and 76 cases underwent routine open surgery. Operative time, complications, blood loss volume, lymph node clearance, postoperative intestinal function recovery, length of hospital stay after surgery, costs were observed and compared between the two groups. Results. Patients underwent laparoscopic surgery showed less blood loss volume, less recovery time, shorter hospi- tal stay, lower incidence of complications but longer operative time （P all 〈0.05）. Besides, there＇s no sig- nificant difference in lymph node clearance, recurrence, and incidence of distant metastasis between the two groups （P〉0. 05）. Conclusions. Laparoscopic operation shows great clinical effects on rectal cancer with advantages of mini-invasion, quick recovery. It is worthy of application in large scale.