3D腹腔镜在直肠癌根治术中的临床应用探究

Clinical application of 3D laparoscopy in radical resection of rectal cancer

目的:探究3D腹腔镜对直肠癌根治术临床疗效的影响及其应用价值。方法:回顾分析2015-06-2017-06期间行腹腔镜直肠癌根治术47例患者临床资料,术中采用3D设备患者24例(3D组,24例),采用2D高清设备患者23例(2D组,23例),对比两组患者术后及随访资料情况。结果:3D组患者术中出血量(77.1±5.5)少于2D组(101.7±8.7,P<0.05)。3D组患者术后并发症(吻合口瘘、吻合口出血、尿潴留及切口感染)发生率(12.5%)低于2D组(39.1%,P<0.05)。在手术时间、术中失血量、淋巴结清扫个数、排气时间、尿管拔除天数、术后住院天数及住院费用方面差异无统计学意义。两组患者随访时间为(15.7±3.6)个月,随访期间3D组与2D组复发率分别为16.7%和21.7%,病死率分别为8.3%和8.7%,两者比较差异无统计学意义。结论:3D腹腔镜直肠根治术的肿瘤治疗效果与2D腹腔镜相当,其术中出血量少,术后并发症发生率低,有助于直肠癌手术的完成,临床应用值得推广。

Objective：To investigate the clinical effects of 3D laparoscopic surgery of radical resection for rectal cancer and its applied values.Method：The clinical information of 47 patients treated with laparoscopic rectal cancer during June 2015 to June 2017 were retrospectively analyzed.They were divided into 3D laparoscopic group（3D group,24 cases）and 2 Dlaparoscopic group（2D group,23 cases）,the clinical effects of two groups were compared.Result：The blood loss during the surgery in 3D group was less than that in 2D group（77.1±5.50 vs 101.7±8.70,P〈0.05）.The rate of complication which contains anastomotic fistula,anastomotic bleeding,urinary retention and incision infection in 3D group was lower than that in 2D group（12.5% vs 39.1%,P〈0.05）.In other respects,such as time of operation,the number of lymphadenectomy,the exhaust time after surgery,postoperative catheter removal days,postoperative hospital days and the whole costs in the hospital,there was no statistical difference between two groups.The follow-up time of two groups was（15.7±3.6）months.The recurrence rates of 3D group and 2D group during follow-up were 16.7%and 21.7%respectively,and the patient mortality were 8.3% and 8.7% respectively.There was no statistical difference between the two groups in these respects.Conclusion：3D laparoscopic radical resection effect is equivalent to 2D laparoscopic treatment,less intraoperative blood loss and lower postoperative complication rate promote the completion of surgery for rectal cancer,which is worth promoting.