腹腔镜与开腹手术治疗结直肠癌术后肠梗阻发生情况对比研究

Postoperative intestinal obstruction of laparoscopic and open operation for the treatment of colorectal cancer

目的探讨腹腔镜与开腹手术治疗结直肠癌术后肠梗阻发生情况对比。方法选取我院自2010年6月至2014年6月收治入院的结直肠癌患者160例,将所有患者随机分为观察组及对照组各80例,观察组患者行腹腔镜下结直肠癌根治术,对照组患者行常规开腹结直肠癌根治术,观察患者手术情况,术后肠道功能恢复情况及肠梗阻发生情况。结果观察组手术时间较对照组长(t=16.639,P<0.05),术中出血较对照组少(t=27.598,P<0.05),术中淋巴结清除个数及近端切缘长度与对照组比较差异无统计意义(P>0.05)。观察组术后进流食,进普食时间及术后排气时间均短于对照组,差异具有统计学意义(t分别为8.402,4.689及3.726,P均<0.05)。观察组较对照组肠梗阻发生率低,差异具有统计学意义(χ2=4.238,P<0.05)。结论腹腔镜结直肠癌根治手术较开腹结直肠癌根治手术出血少,肠道功能恢复较快,在治疗效果上相似,但肠梗阻发生率低,值得临床推广。

Objective To investigate the study of postoperative intestinal obstruction of the laparoscopic and open operation for the treatment of colorectal cancer.Methods 160 cases in our hospital from June 2010~June 2014 year colorectal cancer patients were selected and randomly divided into observation group and control group,with 80 cases in each group.The observation group underwent laparoscopic radical resection for colorectal cancer,and the patients in the control group underwent conventional open resection of colorectal cancer.The operation situation,postoperative intestinal function recovery and the occurrence of intestinal obstruction were observed.Results The operation time in the observation group was longer than the control group（t=16.639,P〈0.05）.The intraoperative bleeding was less in the observation group than that of the control group（t=27.598,P〈0.05）.There was no statistical significance in the lymph node dissection and the number of proximal margin length between the two groups（P〉0.05）.The tine for patients in the observation group beginning with liquids and post-surgery anal-exsufflation were shorter than the control group,which were significant difference（t=8.402,4.689 and 3.726,P〈0.05）.The total intestinal obstruction rate in the observation group was lower than the control group（χ2=4.238,P〈0.05）.Conclusion The laparoscopic colorectal cancer radical surgery compared with open radical surgery is less bleeding,faster in intestinal function recovery,with similar treatment effect.Moreover,lower incidence of intestinal obstruction in the laparoscopic colorectal cancer radical surgery is worth for the clinical promotion.