手辅助腹腔镜与腹腔镜直肠癌根治术的临床对照研究

Comparative Study Between Hand Assisted Laparoscopic Radical Resection and Total Laparoscopic Radical Resection of Rectal Cancer

目的探讨手辅助腹腔镜直肠癌根治术在直肠癌外科治疗中的临床应用价值。方法分析52例施行手辅助腹腔镜直肠癌根治术(手辅助组)和49例施行腹腔镜直肠癌根治术(腹腔镜组)患者的临床资料,比较两组患者的切口长度、手术时间、术中出血量、淋巴结清扫数目、术后腹腔引流量、术后排气时间和术后住院时间的差异。结果手辅助组和腹腔镜组均顺利完成手术。两组的病理检出淋巴结清扫数目、术后腹腔引流量、术后排气时间和术后住院时间比较,差异无统计学意义(P>0.05)。虽然手辅助组的手术切口长度长于腹腔镜组、术中出血量多于腹腔镜组,但手辅助组的手术时间明显少于腹腔镜组(P<0.05)。结论手辅助腹腔镜直肠癌根治术疗效与腹腔镜直肠癌根治术相当,但操作难度降低,手术时间更短。

Objective To evaluate the clinical application of hand assisted laparoscopic radical surgery for rectal cancer.Methods From January 2013 to December 2014,a total of 52 patients underwent hand assisted laparoscopic radical resection for rectal cancer（hand assisted group）and 49 patients underwent total laparoscopic surgery（laparoscopic group）were selected.The perioperative outcomes including incision length,operation time,intraoperative blood loss,numbers of resected lymph nodes,postoperative abdominal drainage,time of bowel function recovery and postoperative hospital stay were compared between two groups.Results Both operations were completed successfully.The hand assisted group showed significantly shorter operation time,longer incision length and more intraoperative blood loss than the laparoscopic group（P〈0.05）.No significant differences were found in numbers of resected lymph nodes,postoperative abdominal drainage,time of bowel function recovery and postoperative hospital stay（P〉0.05）.Conclusion Although effects of both operations were almost similar,hand assisted laparoscopic radical surgery in rectal cancer is less difficult with shorter operation time and can achieve considerable treatment effects as compared with total laparoscopic operation.