腹腔镜和开腹全直肠系膜切除术治疗直肠癌患者的临床短期疗效

Clinical Short-term Curative Effect of Laparoscopic Surgery and Laparotomy Total Mesorectal Excision in Treatment of Patients with Rectal Cancer

目的对比直肠癌患者行腹腔镜和开腹全直肠系膜切除术治疗的临床疗效。方法以该院2014年6月—2016年2月收治的30例直肠癌患者为研究对象,根据治疗方式不同将其分为观察组(n=15例)和对照组(n=15例),对照组采用开腹全直肠系膜切除术治疗,观察组给予腹腔镜全直肠系膜切除术进行治疗,对比2组手术治疗总有效率、短期疗效、手术相关指标情况。结果观察组局部复发率、远处转移率分别为13.33%、20.00%,对照组依次为为33.33%、46.67%,且观察组(86.67%)与对照组1年生存率(80.00%)比较差异无统计学意义(P>0.05)。观察组术中出血量、肛门排气时间等指标与对照组相比差异有统计学意义,且观察组(93.33%)手术治疗有效率明显高于对照组(66.67%),组间数据对比差异有统计学意义(P<0.05)。结论直肠癌患者行腹腔镜全直肠系膜切除术治疗临床疗效优于开腹手术,这种术式效果好,优势明显,患者术中出血量较少,具有在临床推广应用的价值。

Objective To compare the clinical curative effect of laparoscopic surgery and laparotomy total mesorectal excision in treatment of patients with rectal cancer. Methods 30 cases of rectal cancer patients admitted and treated in our hospital from June 2014 to February 2016 were selected and divided into two groups with 15 cases in each according to different treatment methods, the control group were treated with laparotomy total mesorectal excision, while the observation group were treated with laparoscopic total mesorectal excision, and the total effective rate, short-term curative effect and operative related indexes of the two groups were compared. Results The local recurrence rate and distance metastasis rate in the observation group and in the control group were respectively 13.33%,20.00% and 33.33%,46.67%, and the difference in the 1-year survival rate between the observation group and the control group was not statistically significant（86.67% vs 80.00%）（P 〉0.05）, and there were obvious differences in the intraoperative bleeding amount and anal exhaust time between the two groups, and the operative treatment effective rate in the observation group was obviously higher than that in the control group（93.33% vs 66.67%）, and the difference was statistically significant（P〈0.05）. Conclusion The clinical curative effect of laparoscopic total mesorectal excision in treatment of patients with rectal cancer is better than that of laparotomy, and the operative effect is good with obvious advantage and less intraoperative bleeding amount, which is worth promotion and application in clinic.