腹腔镜与传统开腹手术对低位直肠癌根治术的临床效果对比分析

Comparative Analysis of the Clinical Effect of Laparoscopic and Traditional Open Surgery for Low Rectal Cancer

目的探讨腹腔镜与开腹手术在低位直肠癌根治术中的临床应用效果。方法收集低位直肠癌患者68例,其中腹腔镜组患者38例,传统开腹组患者30例,对比分析两组患者的临床效果。结果腹腔镜组患者的手术时间较开腹组长,但术中出血量、手术切口长度、术后排气时间以及住院时间要明显优于开腹组,差异具有统计学意义(P<0.05),两组患者在淋巴结清扫以及手术切缘距癌肿下缘方面差异不具统计学意义(P>0.05)。腹腔镜组(18.4%)与开腹组(16.7%)围手术期并发症发生率比较,差异不具统计学意义(P>0.05)。半年,1年以及2年生存率、复发率以及低位保肛率和总保肛率,两组比较差异不具统计学意义(P>0.05)。结论腹腔镜低位直肠癌根治术对患者的创伤小,利于患者术后恢复,值得临床上推广使用。

Objective To investigate the clinical effect of laparoscopic and open surgery in the treatment of low rectal cancer. Methods 68 patients with low rectal cancer were collected,including 38 cases of laparoscopic group and 30 cases of tra- ditional open group, and the clinical effects of the 2 groups were compared. Results Time of surgery in the laparoscopic group was longer than that of the open surgery group,but intraoperative blood loss,operation incision length,postoperative exhaust time and time of hospitalization were significantly better than those of the open surgery group, the difference had statistical significance （ P 〈 0.05 ） ,lymph node dissection and surgical margin from tumor margin of the 2 groups had no difference （ P 〉 0.05 ）. There was no significant difference in the incidence of perioperative complications between laparoscopic group （ 18.4% ） and open sur- gery group （ 16.7 % ） （ P 〉 0.05 ）. 6-, 12- and 24-month survival rates and recurrence rates, low position anus preservation rates and the total retention rates of the 2 groups had no significant difference （ P 〉 0.05 ）. Conclusion Laparoscoplc resection with small trauma for low rectal cancer is beneficial to postoperative recovery, and it is worthy of clinical use.