腹腔镜和开腹Dixon手术根治直肠癌的短期疗效对比

Coparison of short-term effects between laparoscope and open Dixon radical resection for rectal cancer

目的比较腹腔镜和开腹Dixon手术根治直肠癌的疗效。方法 84例直肠癌患者非随机分为腔镜组44例和开腹组40例,比较两组患者的淋巴结清扫数目、肿瘤距远端切缘的距离、手术所需时间、术中出血量、术后肛门排气时间、术后并发症发生情况、住院时间及住院总费用。结果腔镜组与开腹组的淋巴结活检数目分别为分别为12.91±3.58枚和14.33±3.38枚,肿瘤距远端切缘的距离分别为3.15±0.61cm和3.28±0.74 cm,两组相比较,差异均无统计学意义(P均>0.05)。腔镜组与开腹组的手术时间分别为191.75±23.06 min和154.80±12.99 min,术中出血量分别为132.63±35.73 m L和181.02±75.79 m L,肛门排气时间分别为2.93±1.33天和4.70±1.39天,住院时间分别为11.38±2.00天和16.82±1.85天,住院总费用分别为3.69±0.30万元和3.03±0.37万元,两组相比较,差异均有统计学意义(P均<0.05)。腔镜组和开腹组并发症的发生率分别为9.1%和17.5%,两组比较,差异无统计学意义(P>0.05)。结论腹腔镜Dixon手术根治直肠癌的短期疗效优于开腹Dixon手术。

Objective To compare the short-term effects of laparoscopic versus open Dixon radical resection for rectal cancer. Methods Eighty-four patients with rectal cancer were nonrandomly divided into two groups, the laparoscopic group（n =44） were treated with laparoscopic Dixon radical resection and the open group（n =40） with open Dixon raidcal resection. Short-term effects, including number of resected lymph nodes, distal resection margin, operative time, blood loss, postoperative anal exhaust time, length of stay, hospitalization expenses, and incidence of complications, were observed and compared between the two groups. Results The number of resected lymph nodes（12.91±3.58 vs 14.33±3.38） and distal resection margins（3.15 ±0.61 cm vs 3.28 ±0.74 cm） showed significanly differeces between the two groups（both P〉0.05）. Laparoscopic group was associated with significantly longer operative time（191.75±23.06 min vs 154.80±12.99 min）, less blood loss（132.63±35.73 m L vs 181.02±75.79 m L）, shorter postoperative anal exhaust time（2.93±1.33 d vs 4.70±1.39 d）and length of stay（11.38±2.00 d vs 16.82±1.85 d）, and higher hospitalization expenses（36.9±3.0thousand vs 30.3 ±3.7 thousand）（all P〈0.05）. Incidence of complications was found no difference between the two groups（9.1% vs 17.5%,P〉0.05）. Conclusion Laparoscopic Dixon radical resection is superior to open Dixon radical resection in the management of rectal cancer in terms of improving shortterm efficacy.