腹腔镜在中低位直肠癌手术中的应用

The Effect Comparison of Laparoscopy and Laparotomy for Mid-low Rectal Cancer

目的通过比较腹腔镜与开腹中低位直肠癌手术的临床疗效，探讨腹腔镜中低位直肠癌手术的临床价值。方法回顾性分析2010年1月～2012年1月我科收治的82例中低位直肠癌患者的临床资料，其中42例行腹腔镜手术（腹腔镜组），40例行开腹手术（开腹组），比较两组手术时间、术中出血量、淋巴结清扫范围、肿块距下切缘距离、切除肠管长度、胃肠功能恢复时间、术后住院时间及并发症发生率等指标。结果两组出血量、淋巴结清扫数目、肿块距下切缘距离、切除肠管长度、并发症发生率比较，差异均无统计学意义（P〉0．05）；两组手术时间、胃肠功能恢复时间、术后住院时间比较，差异均有统计学意义（P〈0．05）。结论腹腔镜下中低位直肠癌切除术是可行和安全有效的，与开腹手术对比有较多优点，值得在临床进一步推广应用。

Objective To compare the effects of laparoscopic surgery and open operation in treatment of mid-low rectal cancer. Methods The clinical data of 82 cases of mid-low rectal cancer admitted from Janu- ary 2010 to January 2012 were analyzed retrospectively. Among them, 42 cases were performed laparoscopic surgery （as laparoscopic group） and 40 cases underwent open surgery （as open group）. The operation time, blood loss, the total number of lymph nodes, the distance between the mass and the distal excisional margin, the length of dissected bowel, complications rate, the first exhaust time, and postoperative hospitalization stay time was compared between two groups. Results There was no significant difference in blood loss, total number of lymph nodes, the distance between the mass and the distal excisional margin, the length of dissected bowel and complication rate between two groups （P 〉 0.05） ; but there was statistical difference in operation time, the first exhaust time and postoperative hospital stay time between two groups （P 〈 0.05）. Conclusions Laparoscopic surgery is feasible, safe and effective for mid-low rectal cancer, and has a number of advantages compared with open operation. It is worthy to further popularize.