腹腔镜直肠癌根治术近期疗效分析

Short-term Efficacy of Laparoscopic Radical Resection for Rectal Cancer

目的探讨腹腔镜直肠癌根治术近期疗效分析。方法方便选取2013年3月—2018年3月在该院普外科手术治疗的94例直肠癌患者随机分为两组,对照组采用传统开腹手术治疗,观察组采用腹腔镜直肠癌根治术治疗,比较两组患者的近期疗效、各项手术及恢复指标、并发症发生率。结果观察组切除肿瘤直径(3.1±1.1)cm、直肠切除长度(17.4±1.2)cm、结肠切除长度(10.5±1.0)cm、距下切缘距离(4.4±0.4)cm、淋巴结清扫数(15.8±1.9)个,与对照组的(2.9±1.0)cm、(17.1±1.1)cm、(10.2±1.0)cm、(4.2±0.5)cm、(14.6±2.1)个相比差异无统计学意义(t=0.343,0.372,0.336,0.415, 0.683,P>0.05);观察组切口长度(5.4±1.6)cm、手术时间(164.2±22.3)min、术中出血量(106.8±27.4)mL、术后排气时间(2.8±0.7)d、下床活动时间(4.8±1.2)d、住院时间(10.2±2.4)d与对照组的(15.5±2.3)cm、(136.5±17.4)min、(159.2±33.7)mL、(3.6±1.0)d、(5.9±1.3)d、(13.3±2.8)d相比均差异有统计学意义(t=5.672,4.414,4.708,4.303,4.032,4.478,P<0.05);观察组肠梗阻、吻合口瘘、吻合口出血、切口感染、尿路感染、肺部感染等并发症发生率为8.51%(4/47),明显高于对照组的27.66%(13/47),差异有统计学意义(χ~2=11.84,P<0.05)。结论腹腔镜直肠癌根治术近期疗效与开腹手术相当,但创伤更小,术后恢复更快,且并发症发生率更低,优势更为明显。

Objective To investigate the short-term efficacy of laparoscopic radical resection for rectal cancer.Methods 94 patients with rectal cancer who underwent general surgery in the hospital from March 2013 to March 2018 were convenient selected randomly divided into two groups.The control group was treated with traditional open surgery and the observation group was treated with laparoscopic radical resection.The short-term efficacy,various surgical and recovery indexes,and complication rates were compared between the two groups.Results The diameter of the resected tumor was (3.1±1.1)cm,the length of rectal resection (17.4±1.2)cm,the length of colon resection (10.5±1.0)cm,the distance from the incision margin (4.4±0.4)cm,and the number of lymph node dissection (15.8±1.9),compared with the control group (2.9±1.0)cm,(17.1±1.1)cm,(10.2±1.0)cm,(4.2±0.5)cm,(14.6±2.1),no significant difference (t=0.343,0.372,0.336,0.415,0.683,P>0.05);observation group incision length (5.4±1.6)cm,operation time (164.2±22.3)min,intraoperative blood loss (106.8±27.4)mL,postoperative exhaust time (2.8±0.7)d,time to get out of bed (4.8±1.2)d,length of hospital stay (10.2±2.4)d,and control group (15.5±2.3)cm,(136.5±17.4)min,(159.2±33.7)mL,(3.6±1.0)d,(5.9±1.3)d,(13.3±2.8)d were significantly different (t=5.672,4.414,4.708,4.303,4.032,4.478,P<0.05);observation group of the incidence of complications such as intestinal obstruction,anastomotic leakage,anastomotic bleeding,wound infection,urinary tract infection,and pulmonary infection was 8.51%(4/47),which was significantly higher than that of the control group 27.66%(13/47),the difference was statistically significant (χ^2=11.84,P<0.05).Conclusion The short-term effect of laparoscopic radical resection for rectal cancer is comparable to that of open surgery,but the trauma is smaller,the recovery is faster,the complication rate is lower,and the advantage is more obvious.