腹腔镜与开腹手术治疗直肠癌的短期效果及安全性分析

Comparative analysis on short-term efficacy and safety of laparoscopic and open surgery for the treatment of colorectal cancer

目的探讨腹腔镜与开腹直肠癌根治术用于直肠癌患者的短期疗效及安全性。方法选取2011年4月-2014年10月我院收治的124例直肠癌患者作为研究对象,采用随机数字表法将所选患者分为研究组和对照组,各62例,研究组采用腹腔镜直肠癌根治术治疗,对照组采用开腹直肠癌根治术治疗,综合比较两组患者近期疗效指标及并发症情况。结果两组患者手术时间、清扫淋巴结数目比较,差异无统计学意义（P〉0.05）;研究组术中出血量少于对照组,差异有统计学意义（P〈0.05）;术后排气时间、进食固体饮食时间及住院时间分别为（2.1±0.7）、（4.2±1.1）、（18.6±3.2）d,均短于对照组,差异有统计学意义（P〈0.05）;研究组患者发生切口感染、肺部感染、吻合口瘘及直肠阴道瘘等并发症发生率为14.5%,显著低于对照组30.6%,差异有统计学意义（P〈0.05）。结论腹腔镜直肠癌根治术在近期疗效方面有明显优势,安全性高,与传统开腹手术比较,具有创伤小、术中出血少、术后恢复快及并发症少等优点,值得临床推广使用。

Objective To compare the short-term efficacy and safety of laparoscopic and open surgery for the treatment of colorectal cancer. Methods 124 cases of colorectal cancer in our hospital were randomly divided into research group and control group,each were 62 cases.Research group was treated with laparoscopic surgery.Control group was treated with open surgery.The short-term efficacy indicators and complications were compared. Results The operation time and number of lymph nodes dissection of two groups had no statistically significant（P〈0.05）.The blood loss of research group was lower than control group（P〈0.05）.The postoperative exhaust time,eating solid food time and hospital stay of research group was（2.1±0.7）d,（4.2±1.1）d and（18.6±3.2）d,which was shorter than that of control group respectively（P〈0.05）.The complications rate like incision infection,pulmonary infection,anastomotic fistula and rectovaginal fistula of research group was 14.5%,which was lower than 30.6% of control group（P〈0.05）. Conclusion There are obvious advantages in the short-term efficacy of laparoscopic surgery with high safety,small trauma,less intraoperative bleeding,rapid recovery and less complications compared with traditional open operation.It′s worthy of clinical widely used.