传统开腹与腹腔镜下直肠癌根治术短期疗效对比

Short-term effects of traditional open and laparoscopic radical resection on rectal cancer

目的探讨传统开腹手术与腹腔镜下直肠癌根治术的短期疗效及安全性。方法选取接受治疗的直肠癌患者112例作为研究对象,采用随机数字表法分为腹腔镜组与开腹组,对比两组患者围术期的情况、短期疗效及并发症的发生情况。结果与开腹组相比,腹腔镜组切口长度、术后排气时间、下床活动时间及住院时间均显著缩短,术中出血量也显著减少,手术时间显著延长,差异有统计学意义(P<0.05);两组患者在术后结肠与直肠的切除长度、肿瘤直径、肿瘤与下切缘的距离及淋巴结清扫数目对比差异未见统计学意义(P>0.05);腹腔镜组为7.14%,开腹组并发症发生率为37.50%,差异有统计学意义(P<0.05)。结论腹腔镜下直肠癌根治术术中出血量少、手术时间短、术后恢复时间短,肿瘤根治情况与开腹术无显著差别,但总体短期疗效优于开腹术,值得临床推广应用。

Objective To investigate the short-term efficacy and safety of traditional open surgery and laparoscopic rad- ical resection of rectal cancer. Methods A total of 112 patients with rectal cancer in our hospital were selected as the ob- jects. Using random number table method, the patients were divided into laparoseopic group and laparotomy group. The perioperative period conditions, short-term efficacy and complications were compared. Results Compared with open sur- gery, the incision length, postoperative exhaust time, get out of bed activity time and hospital stay in laparoscopic group were significantly shortened, intraoperative bleeding was significantly reduced, operation time was significantly prolonged, the differences were significant （P 〈 0.05）. There was no significant difference in the postoperative colon and rectum re- section length, tumor size, tumor and cut edge distance or lymph node dissection number （P 〉 0. 05）. The incidence of complications in laparoscopic group was 7.14% and 37.50% in the laparotomy group, the difference was significant （P 〈 0. 05）. Conclusion Laparoscopic radical resection of rectal cancer surgery has little hemorrhage quantity, short operation time, short postoperative recovery time, the same effect on rectal cancer as open surgery, but the overall short-term effect is better than that of open surgery, so it is worth of clinical application.