腹腔镜与开腹低位直肠癌Miles术疗效与安全性的对照研究

Comparative study on efficacy and safety of laparoscopic Miles surgery versus open procedure for lower rectal cancer

目的 比较腹腔镜与开腹直肠癌Miles术在低位直肠癌治疗中的疗效与安全性. 方法 选取我院2009-06～2014-06收治的163例低位直肠癌患者作为研究对象,参照患者选取的手术方式将其分为腹腔镜组75例与开腹组88例,其中腹腔镜组患者行腹腔镜Miles术,开腹组患者行开腹Miles术,比较两组患者的手术疗效与安全性、术后并发症情况.结果 腹腔镜组患者的术中出血量、术后并发症发生率明显少于开腹组（P＜0.05）,术后恢复明显快于开腹组（P＜0.05）,腔镜组手术平均用时、淋巴结清扫数量、近期复发率和病死率与开腹组相比差异无统计学意义（P＞0.05）. 结论 两种手术治疗方法均能在低位直肠癌治疗应用中获得良好的临床效果,但与传统的低位直肠癌开腹手术相比,腹腔镜Miles术创伤更小,且术后恢复快,并发症发生率低,总体安全性更高.

Objective To compare the clinical efficacy and safety of laparoscopic Miles surgery versus open procedure for lower rectal cancer.Methods Totally 163 cases of lower rectal cancer in our hospital from June 2009 to June 2014 were selected and divided into laparoscopy group（n =75） and open procedure group（n =88） according to surgical method.The efficacy,safety and complications between two groups were compared.Results The bleeding volume and the incidence of postoperative complications were lower in laparoscopy group than in open procedure group（P ＜ 0.05）,while the postoperative recovery process was faster in laparoscopy group than in open procedure group（P ＜ 0.05）.The operation time,the mean number of removed lymph nodes,the recent recurrence rate and the fatality between laparoscopy group and open procedure group were not significantly different （P ＞ O.05）.Conclusion Two surgical methods have good clinical effect on lower rectal cancer.But compared with open procedure of Miles surgery,laparoscopic Miles surgery can reduce operation wound and complications and improve postoperative recovery with higher safety.