腹腔镜直肠癌手术与开腹直肠癌手术的疗效对比研究

Study on comparison of effect laparoscopicrectectomy with open rectectomy in treatment of cancer

目的探讨腹腔镜手术与开腹手术治疗低位直肠癌的近期疗效、肿瘤根治性及主要并发症。方法回顾我院2004年1月至2011年1月收治的211例低位直肠癌,据手术方式不同分组:腹腔镜手术治疗85例(腹腔镜组),开腹手术治疗126例(开腹组),比较两组术中、术后及愈后指标。结果腹腔镜组术中出血量、术后胃肠功能恢复时间及术后住院时间优于开腹组(P<0.05)。两组保肛率、清扫淋巴结数量、术后肠梗阻、术后吻合口出血、吻合口漏、局部复发率、5年生存率、无瘤生存率各项差异无统计学意义(P>0.05)。结论腹腔镜治疗低位直肠癌近期疗效总体优于开腹组,远期疗效相当,具有微创、恢复快等优点。

Objective To explore the short-term,radical cure and main complications outcome of laparo- scopic radical resection and open procedures for resection of low rectal cancer. Methods The clinical data of 211 cases of low rectal cancer treated from January 2004 to January 2011 were analyzed. The patients were divided into two groups according to different surgical procedure. There were 85 cases in laparoscopic re- section group, and 126 cases in open procedure group. The operative procedures, clinicopathological data and short-term outcomes were collected and campared. Results It had signigicant differences between the two groups in terms of bleeding, the time for intestinal functional recovery and length of hospital stay（P〈 0.05）. No significant differences were observed between the two groups in rate of anal sphincter terms of the operation time, the number of lymph node,intestinal obstruction, anastomotic bleeding, anastomotic fistula, local relapse,5 year survival rate, and disease free survival（ P〉0.05）. Conclusion Compared to open surgery, the laparoseopic procedure for low rectal cancer has better efficacy in short-term and in similar in long-term outcome, and it has advantages of Minimally invasive and quick recovery.