全腹腔镜下直肠癌根治术与开放手术对保留生理功能的安全性及远期疗效观察

Safety and Long-term Effect Observation on Physiofunction-Saving in Rectal Carcinoma Treated with Panlaparoscopic Radical Procedure and with Open Operation

为观察全腹腔镜下直肠癌根治术与开放手术对保留直肠癌患者生理功能的安全性及远期疗效,将216例直肠癌患者按照手术方案的不同随机分成观察组和对照组,每组108例。观察组患者采用全腹腔镜下直肠癌根治术治疗,对照组患者采用开放手术治疗,分别对2组患者的手术指标、术后并发症、复发率、生存率及男性患者性功能进行比较。结果显示,2组患者的淋巴结扫除数量差异不明显,观察组患者手术时间长于对照组患者,但观察组患者在出血量、住院时间及疼痛评分方面均明显优于对照组;2组患者的并发症发生率比较有显著性差异;2组患者1年后复发率及生存率差异不明显,观察组患者3年后复发率明显低于对照组、生存率明显高于对照组;2组男性患者的性功能比较有显著性差异。结果表明,全腹腔镜下直肠癌根治术对保留生理功能的直肠癌患者其疗效与开放手术差异不大,但术中出血量少、疼痛轻、住院时间短、术后并发症少、3年后复发率低、3年后生存率高,男性患者的性功能保留度较高,具有更广阔的应用前景。

This study was to observe the safety and long-term effect of physiofunction-saving in rectal carcinoma patients treated with panlaparoscopic radical procedure and with open operation,randomly divided 216 cases of rectal carcinoma into observation group （ n = 108, with panlaparoscopic radical procedure） and control one（ n =108, with open operation） ; then compared both groups＇ operative norms, postoperative complication, recurrence rate, survival rate, as well as male patients＇ sex function.As results, in the number of lymph removed there was no statistical difference between the two groups;in operative time the former was longer than the latter,but significantly superior to the latter in bleeding volume,in the score on hospi- tal stay,and on pain; in complication incidence there was a significant difference;in post-1 yr. recurrence rate and survival rate there was no significant difference, but in post-3 yr. recurrence rate and survival rate the former was significantly lower and higher than the latter;in male patient＇s sex function there was a significant difference.Results show that above-mentioned procedures for physiofunction-saving have no difference in the effect, but panlaparoseopic radical procedure has less intraoperative bleeding volume, milder pain, short hospital stay, less complication, lower post-1 yr. recurrence rate, and higher survival rate,＇as well as male patient＇s sex function-preserving degree than open operation.It has a wider application prospect.