腹腔镜与开腹Miles手术治疗低位直肠癌的临床研究

Laparoscopic and open Miles surgery in the treatment of low rectal cancer

目的对比分析腹腔镜与开腹Miles手术治疗低位直肠癌的疗效。方法选择83例低位直肠癌患者,依据随机数字表法将患者分为腹腔镜组(n=42)和开腹组(n=41),观察记录两组患者的术中指标、术后恢复情况及术后并发症发生率。结果腹腔镜组与开腹组患者的手术时间和淋巴结清扫数目比较,差异均无统计学意义(P﹥0.05);但腹腔镜组患者的术中出血量少于开腹组(P﹤0.05),胃肠道功能恢复时间、自主排尿时间、术后下床活动时间、术后住院时间、进食恢复时间均明显短于开腹组(P﹤0.01),并发症总发生率低于对照组(P﹤0.05)。结论腹腔镜Miles手术治疗低位直肠癌能达到开腹Miles手术的切除范围,且术中出血量少、创伤小、术后恢复快、住院时间短、术后并发症发生率低,值得临床推广应用。

Objective To compare the curative effect of laparoscopic and open Miles surgery in the treatment of low rectal cancer. Method 83 cases of low rectal cancer patients were enrolled in the study, randomized as laparoscopic surgery group（n=42） or open surgery group（n=41） as per a random number table, of which the intraoperative measures,postoperative recovery and incidence of complications were observed and recorded. Result There was no significant difference between the two groups in regard of operative time and the number of lymph nodes dissection（P〈0.05）; but the laparoscopic surgery group had less intraoperative blood loss, shorter time to gastrointestinal function recovery, to spontaneous micturition, to postoperative ambulation, shorter hospital stay, and less time to diet recovery compared with open surgery group（P〈0.01）, and the overall incidence of complications were also significantly lower in patients administered with laparoscopic surgery（P〈0.05）. Conclusion Laparoscopic Miles surgery achieves comparable resection range with open Miles surgery in the treatment of low rectal cancer, with less blood loss, smaller wound, faster recovery, shorter hospital stay, and less postoperative complications.