直肠癌腹腔镜辅助与开腹全直肠系膜切除术治疗42例患者的对照研究

Control study of laparoscope-assisted rectal cancer operation and laparotomy total mesorectal excision in the treatment of 42 patients with rectal cancer

目的比较腹腔镜辅助与开腹全直肠系膜切除术在治疗直肠癌方面的短期疗效及并发症差异。方法 42例直肠癌患者,按照患者自愿选择手术方式不同分为腹腔镜组和开腹组,各21例。腹腔镜组患者采用直肠癌腹腔镜辅助手术治疗;开腹组患者采用开腹全直肠系膜切除术治疗。术后比较两组患者远期转移率、局部复发率、并发症发生率。结果两组患者局部复发率、远期转移率比较,差异均无统计学意义(P>0.05)。腹腔镜组粘连性肠梗阻发生率为0,低于开腹组的23.8%,差异有统计学意义(P<0.05);两组患者切口种植、切口疝发生率比较,差异均无统计学意义(P>0.05)。结论直肠癌腹腔镜辅助手术治疗较开腹全直肠系膜切除术治疗疗效更佳。

Objective To compare short-term curative effects and difference of complications between laparoscope-assisted rectal cancer operation and laparotomy total mesorectal excision in the treatment of rectal cancer. Methods A total of 42 patients with rectal cancer were divided by different surgery measures into laparoscope group and laparotomy group, with 21 cases in each group. The laparoscope group received laparoscope-assisted rectal cancer operation for treatment, and the laparotomy group received laparotomy total mesorectal excision for treatment. Comparison was made on long-term metastasis rate, local recurrence rate, and incidence of complications after operation between the two groups. Results There was no statistically significant difference of local recurrence rate and long-term metastasis rate between the two groups（P〈0.05）. The laparoscope group had lower incidence of adhesive intestinal obstruction as 0 than 23.8% in the laparotomy group, and their difference had statistical significance（P〈0.05）. The differences of incidence of port site implantation and incisional hernia between the two groups had no statistical significance（P〈0.05）. Conclusion Laparoscopeassisted rectal cancer operation provides better curative effect than laparotomy total mesorectal excision.