低位直肠癌腹腔镜与开腹根治术近期效果比较

Comparison of short-term clinical effects of laparoscopic and open radical resection in treatment of low rectal cancer

目的:探讨腹腔镜与开腹根治术治疗低位直肠癌的近期效果,为临床诊断治疗提供参考。方法:将70例低位直肠癌患者随机分为腹腔镜组(n=36)与开腹组(n=34),对比两组患者手术时间、术中出血量、术后肛门排气时间、术后尿管留置时间、术后住院时间及并发症发生情况。结果:腹腔镜组手术时间显著长于开腹组,差异有统计学意义(P<0.05);腹腔镜组术中出血量显著少于开腹组,差异有统计学意义(P<0.05);两组术后远端切缘长度、淋巴结扫清数量差异无统计学意义(P>0.05);腹腔镜组术后肛门排气时间、尿管留置时间、术后住院时间均优于开腹组,差异有统计学意义(P<0.05);腹腔镜组术后并发症总发生率显著低于开腹组,差异有统计学意义(P<0.05)。结论:低位直肠癌患者行腹腔镜手术可达到开腹手术的近期疗效,且具有出血少、切口小、术后康复快、并发症发生率低等优点,值得临床推广应用。

Objective： To investigate the short-term clinical effects of laparoscopic and open radical resection in treatment of low rectal cancer in order to provide reference for clinical diagnosis and treatment. Methods： Seventy patients with low rectal cancer were randomly divided into the laparoscopic group（ n = 36） with laparoscopic surgery and open surgery group（ n = 34） with traditional open radical surgery. The operative time,blood loss,anal exhaust time,postoperative catheter indwelling time,the average length of hospital stay and postoperative complications of both groups were compared. Results： The operative time of laparoscopic group was significantly longer than that of the open surgery group,and the difference was statistically significant（ P 0. 05）. The blood loss of laparoscopic group was significantly less than that of the open surgery group,and the difference was statistically significant（ P 0. 05）. There was no significant difference in distal edge length and the number of lymph nodes cleared between 2 groups（ P 0. 05）. The anal exhaust time,postoperative urinary catheter retention time,mean postoperative hospital stay time of laparoscopic group were significantly less than those of open surgery group,and the differences were statistically significant（ P 0. 05）. The overall incidence of postoperative complications of laparoscopic group was significantly lower than that of open surgery group,and the difference was statistically significant（ P 0. 05）. Conclusions： Compared with open radical resection,laparoscopic radical resection in treatment of low rectal cancer possesses similar short-term effect,and the advantages of less blood loss,shorter incision,faster recovery and lower complication rate,and is worthy of clinical promotion and application.