腹腔镜与开腹直肠癌手术近期疗效对比

Comparative analysis of short-term outcomes of laparoscopic and open surgery for rectal cancer

目的比较腹腔镜与开腹直肠癌手术治疗的近期疗效。方法回顾性分析2009年1月至2012年3月首都医科大学附属北京友谊医院普外科直肠癌手术病例共138例,其中,腹腔镜手术82例,开腹手术56例,对比2组手术的近期疗效,包括手术根治性、术中情况、术后恢复情况及术后合并症等几方面。结果腹腔镜组与开腹组术中出血分别为(103.0±93.1)mL和(158.0±130.1)mL,术后使用镇痛人数分别为18(22.0%)和29(51.8%),术后排气时间分别为(2.4±0.6)d和(2.8±0.9)d,术后排便时间分别为(3.3±1.0)d和(3.7±1.3)d,术后进食时间分别为(3.8±1.3)d和(4.6±2.0)d,住院时间分别为(19.6±7.1)d和(22.0±9.1)d,术后合并症发生率分别为14(17.1%)和21(37.5%),以上各项指标比较,差异均有统计学意义(P<0.05),其余各项指标之间比较,差异无统计学意义。结论腹腔镜直肠癌手术具有同开腹手术相同的根治效果,而且具有住院时间短、术中出血少、术后疼痛轻、胃肠功能恢复快及术后合并症少等优势。

Objective To conduct a comparative analysis of short - term outcomes of laparoscopic and open surgery for rectal cancer. Methods Retrospective analysis was performed on 138 cases who underwent rectal cancer surgery in Beijing Friendship Hospital from January 2009 to March 2012. The cases were divided into laparoscopic surgery group （ n = 82） and open surgery group （ n = 56）. The short - term outcomes, including radical therapeutic effect of surgery, intraoperative details, postoperative recovery and postoperative complications were compared between the two groups. Results The blood loss of laparoscopic group and open surgery group were （ 103. 0 ± 93. 1 ） mL and （ 158. 0 ± 130. 1 ）mL. The postoperative analgesia number was 18 （22. 0% ） and 29 （51.8%）, flatus time was （2. 4 ± 0. 6） days and （2. 8 ± 0. 9） days, defecation time was （3.3 ± 1.0） days and （3. 7 ± 1.3） days, the postoperative feeding time was （3.8 ± 1.3 ） days and （4. 6 ± 2. 0） days, hospital stay was （ 19. 6 ± 7. 1 ） days and （22. 0 ± 9. 1 ） days, postoperative complication rates were 14 （ 17. 1% ） and 21 （37. 5% ）. The differences mentioned above were statistically significant （ P 〈 0. 05 ）, and there were no significant differences in the rest of the compared indicators. Conclusion The laparoscopic rectal cancer surgery can achieve the similar radical therapeutic effect as the open surgery. Besides that it has the advantages of shorter hospital stay, less blood loss, less postoperative pain, faster recovery of gastrointestinal function and fewer complications.