腹腔镜直肠癌根治术疗效分析

Effect analysis of laparoscopic radical resection for rectal cancer

目的评价腹腔镜手术与传统开腹手术治疗直肠癌的疗效。方法 2009年9月～2010年9月泸州医学院附属医院共实施腹腔镜直肠癌手术128例,选取同一时期行传统开腹直肠癌手术126例,回顾性比较两组根治性、手术时间、术中及术后并发症、术后肠道功能恢复时间、30 d病死率、1年总存活率及无病存活率等情况。结果腹腔镜组与开腹组比较,在手术时间、术中出血、术后肠道功能恢复时间、术后住院时间等差异有显著性。而术中及术后并发症、淋巴结清扫数目、30 d病死率、1年总存活率及无病存活率比较差异无显著性。结论腹腔镜手术是一种适宜的方式,可获得与传统开腹手术相同的根治效果。尽管腹腔镜手术时间较长,但在术中出血、术后肠道功能恢复时间及术后住院时间方面体现了优势。腹腔镜手术的长期预后尚需随访。

【Objective】To evaluate the feasibility of laparoscopic radical resection and open procedures for rectal cancer. 【Methods】 128 patients with rectal cancer were performed laparoscopic radical resection between September 2009 and September 2010 at Department of General Surgery of the Hospital Affiliated Luzhou Medical College.126 patients who underwent open radical resection in the same period with the same diseases were retrospectively analyzed, the radical effect, operation time, intra and post-operative complications, time of bowel function rehabilitation, post-operative hospital stay, 30-day mortality, 1 years＇ disease free survival and overall survival were compared. 【Results】Both groups obeyed the surgical principle of rectal cancer including extent of resection and bowel margins. Significant differences were shown between laparoscopic and open surgery groups in operation time,intra-operative hemorrhage, time of bowel function rehabilitation and post-operative hospital stay. There was no differences between the two groups in other intra and post-operative complications, lymph nodes harvested, 30-day mortality, 1 years＇ overall survival and disease free survival. 【Conclusion】Laparoscopic radical resection can be a proper choice for curable rectal cancer, which can get the same radical effect and short-term outcome compared with open procedure. Besides, laparoscopic surgery provides advantages in intra-operative hemorrhage, time of bowel function rehabilitation and post-operative hospital stay, although it may take longer time in the duration of operation.The long-term prognosis of laparoscopic surgery need to be confirmed in further follow-up.