腹腔镜下直肠癌前侧切除术治疗直肠癌的效果

Curative effect of laparoscopic rectal anterior resection for rectal cancer

目的探讨腹腔镜下直肠癌前侧切除术治疗直肠癌的效果观察。方法选取2012年1月-2014年1月重庆市开县人民医院收治的直肠癌患者122例,60例患者行开腹直肠癌切除术,作为对照组;62例患者行腹腔镜下直肠癌前侧切除术作为观察组。对两组患者治疗效果及并发症、预后进行统计分析。结果观察组完全缓解21例,部分缓解25例,对照组完全缓解11例,部分缓解14例;对照组的总有效率为41.66%,显著低于观察组的74.19%,差异有统计学意义（P〈0.05）。观察组患者术中出血〉60 mL者12例,切口感染5例,吻合口瘘1例,无腹腔粘连者;对照组患者术中出血量〉60 mL者57例,切口感染19例,腹腔粘连5例,吻合口瘘9例,两组比较差异均有统计学意义（P〈0.05）。两组患者3年生存率及复发率比较,差异均有统计学意义（P〈0.05）。结论腹腔镜下直肠癌前侧切除术具有创伤小、恢复快、并发症少、生存率高及复发率低等众多优势,治疗效果优异,值得临床大力推行。

Objective To observe the clinical effect of laparoscopic rectal anterior resection for rectal cancer. Methods122 patients with rectal cancer from January 2012 to January 2014 in Kaixian People＇s Hospital of Chongqing City were selected, 60 patients underwent open resection for rectal cancer were as control group and 62 cases underwent laparoscopic anterior resection of rectal cancer were taken as observation group. The treatment effects, complications and prognosis of two groups were statistically analyzed. Results 21 cases with completely relieve, 25 cases was partial relieve in the observation group, and 11 cases was complete relieve, 14 cases was partial relieve in the control group; the total efficiency of the observation group（74.19%） was higher than that of the control group（41.66%）, the difference was statistically significant（P〈0.05）. There were 12 cases with intraoperatve blood soss 〉60 mL in the observation group,5 cases of incision infection, 1 case of anastomotic fistula, no abdominal adhesion case; there were 57 cases with intraoperatve blood soss 〉60 mL in the control group, 19 cases of incision infection, 5 cases of abdominal adhesions, 9 cases of anastomotic fistula, the differences between two groups were statistical significance（P〈0.05）. 3 years survival rate and recurrence rate of two groups had difference, with statistically significant difference（P〈0.05）. Conclusion Laparoscopic anterior resection of rectal cancer has the follow advantages： less trauma, faster recovery, less complication, high survival rate and low recurrence rate and so on, its therapeutic effect is excellent, so it is worthy of clinical vigorously.