腹腔镜与开腹直肠癌全直肠系膜切除治疗直肠癌临床效果对照研究

Control study on clinical effect of laparoscopic VGTSUS open resections for rectal cancer

目的探讨腹腔镜和开腹直肠癌全直肠系膜切除术(TME)在治疗直肠癌中的临床效果。方法我院2009年1月～2011年1月来我院进行直肠癌手术的85例患者,随机分别进行开腹组42例和腹腔镜组43例,两组均采用全直肠系膜切除术,随访12个月观察两组患者临床效果。结果腹腔镜组手术时间明显高于开腹组患者,差异具有明显的统计学意义(P>0.05),腹腔镜组患者术中出血量,肛门排气时间,住院天数,术后下床活动时间,导尿管留置时间等均明显低于开腹组,差异具有明显的统计学意义(P<0.05),两组患者尿不尽感,尿急,排尿断续,尿流无力,局部复发率,1年生存率及1年远处转移率,两组患者比例差异两组无明显的统计学意义(P>0.05)。结论腹腔镜TME和开腹TME治疗直肠癌的疗效相同,但是腹腔镜TME具有创伤小,术后恢复快等优势。

Objective To clinical effect after radical resection with total mesorectal excision under the laparoscope and open surgery.Methods The study included 85patients who underwent surgery for rectal cancer between January 2009 and January 2011.They were randomized to laparotomy group of 42 cases and 43 cases of laparoscopic group,both groups with total mesorectal excision,follow-up of 12 patients were observed clinical effect.Results The laparoscopic operative time was significantly higher than the laparotomy group patients,the difference was statistically significant（P0.05）,the laparoscopic group of patients with intraoperative blood loss,flatus,length of stay,postoperative ambulation time,catheterization time and so was significantly lower than the laparotomy group,the difference was statistically significant（P0.05）,not the sense of two groups of patients with urinary urgency,urination,intermittent,urinary inability of local recurrence rate,1-year survival and 1-year distant metastasis rate,the proportion of patients were differences there was no statistically significant（P0.05）.Conclusions The efficacy of laparoscopic TME and open TME for rectal cancer,laparoscopic TME with less trauma,rapid recovery advantages.