腹腔镜低位直肠癌保肛根治术98例分析

Analysis on 98 Cases with Low Rectal Cancer by Laparoscopic SphincterPreserving Radical Surgery

目的:探讨腹腔镜下保肛治疗低位直肠癌的疗效观察。方法:采用前瞻性研究方法,选取我院自2002年1月至2012年6月间收治的低位直肠癌患者186例作为研究对象,按照手术方式的不同分为腔镜组和开腹组,对两组的围手术期相关指标、术后相关并发症及术后生活质量进行比较。结果:腔镜组和开腹组围手术期指标手术时间、术中出血量、胃肠功能恢复时间、住院天数、住院费用等方面进行比较,差异有统计学意义(P<0.05)。腔镜组术后总的并发症发生率为6.12%(6/98),开腹组术后总的并发症发生率为15.31%(15/98),两组总并发症的发生效率比较,差异有统计学意义(P<0.05)。术后1年,两组患者生活质量进行比较,腔镜组优良率为96.72%(59/61),开腹组优良率为81.97%(50/61)。两组优良率进行比较,差异有统计学意义(P<0.05)。结论:在达到肿瘤根治的前提下,腹腔镜下保肛治疗低位直肠癌能最大程度地保留盆腔神经功能,更好提高患者术后生存质量。

Objective： To expore laparoscopic curative effect observation by laparoscopic sphincter-preserving radical surgery. Methods： By prospective studies method, 186 cases with low rectal cancer patients were selected from January 2002 to June 2012, according to the different methods of operation ,they were divided into laparoscopic group and laparotomy group,perioperative related parameters,postoperative complications and postoperative quality of life of two groups were compared. Results：perioperative indicators of operation time, intraoperative blood loss, gastrointestinal function recovery time, hospitalization days, hospitalized expense of two groups were compared, the difference was statistically significant （P〈0.05）. overall complication rate of laparoscopic group was 6.12% （6/98）,total postoperative complication rate of laparotomy group was 15.31% （15/98）, two groups of total complications efficiency had a comparison, the difference was statistically significant （P〈0.05）. After 1 year, quality of life of two groups were compared, laparoscopic group was 96.72% （59/61）, laparotomy group was 81.97% （50/61）. Two groups was compared, the difference was statistically significant （P〈0.05）. Conclusion： Under the premise of a radical cure, laparoscopic sphincter-preserving radical surgery treatment of low rectal cancer can maximize the retention pelvic nerve function, and better improve the quality of patients with postoperative survival.