腹腔镜与传统开腹直肠癌前切除术治疗直肠癌近期疗效比较

Comparison of short-term treatment outcomes between laparoscopic anterior resection and open surgery for rectal cancer

目的比较腹腔镜直肠癌前切除术与传统开腹手术治疗直肠癌的近期疗效。方法选择本院2013年2月至2016年8月收治的82例直肠癌患者为研究对象,随机分为腹腔镜组和开腹手术组(每组各41例),比较两组手术时间、术中失血量、远端切缘距离、平均淋巴结清扫数目、术后留置引流管时间、肛门排气时间、开始进食时间、止痛药使用情况、平均住院时间及住院期间切口感染、肺部感染、吻合口漏、肠梗阻、吻合口出血等并发症发生情况。结果腹腔镜组术中失血量、术后留置引流管时间、开始进食时间、肛门排气时间、平均住院时间均明显短于或低于开腹手术组,止痛药使用率少于开腹手术组(均P<0.05)。腹腔镜组手术时间较长(P<0.05),两组平均淋巴结清扫数目、远端切缘距离比较差异无统计学意义(P>0.05)。两组并发症总发生率差异无统计学意义(P>0.05)。结论腹腔镜直肠癌前切除术治疗直肠癌与传统开腹手术比较肿瘤根治效果相当,且具有创伤小、出血量少、术后恢复快等优点。

Objective To comparison the short-term treatment outcomes between laparoscopic anterior resection and open surgery for rectal cancer. Methods Retrospective analysis was made on the clinical data of 82 patients with rectal cancer from February 2013 to August 2016, in which 41 patients underwent laparoscopic surgery（laparoscopic group） and 41 patients underwent open surgery（open group）. The operation time, operative blood loss, resection margin, number of lymphadenectomy, the postoperative drainage time, the anal exhaust time, diet recovery time, analgesic use, hospitalization between the two groups and incidence of incision infection, lung infection, anastomotic leakage, intestinal obstruction, anastomotic bleeding in during hospitalization were compared. Results The operative blood loss, postoperative drainage time, diet recovery time, the anal exhaust time, analgesic use and hospitalization duration in the laparoscopic group were significantly shorter or lower than those in the open group（P〈0.05）. However operation time in the laparoscopic group were significantly longer（P〈0.05）. There was no significantly difference in number of lymphadenectomy and resection margin between the two groups（P〉0.05）. The total incidence rate of complications in the laparoscopic group was lower than that in the open group, but there was no significantly difference between the two groups（P〉0.05）. Conclusion Compared with the open operation, the laparoscopic anterior resection has the advantages of small trauma, less blood loss and rapid recovery.