腹腔镜与开腹直肠全系膜切除术在低位直肠癌的治疗中的临床疗效分析

Clinical Analysis of Laparoscopic and Open Rectal Mesorectal Excision in the Treatment of Low Rectal Cancer

目的分析低位直肠癌中的开腹和腹腔镜直肠全系膜切除术治疗效果。方法方便选取该院2017年3月—2018年6月收治的84例低位直肠癌患者为研究对象,根据治疗方法不同分为对照组与观察组。对照组42例,采用开腹直肠全系膜切除术治疗,观察组42例,采用腹腔镜直肠全系膜切除术治疗。对两组患者住院时间、肠道功能恢复时间及治疗效果进行观察对比。结果对照组平均住院时间(18.3±2.6)d与肠道功能恢复时间(4.8±1.6)d均明显大于观察组(10.2±4.4)d、(2.2±1.7)d,比较差异有统计学意义(t=2.67、2.89,P<0.05)。对照组平均术中出血量(133.7±17.6)m L与术后下床时间(31.5±6.2)h均明显大于观察组(85.6±15.3)mL、(16.8±5.8)h,比较差异有统计学意义(t=2.96、2.88,P﹤0.05);对照组总并发症发生率明显大于观察组(19.04%﹥2.38%),比较差异有统计学意义(χ~2=7.8,P﹤0.05)。结论与开腹直肠全系膜切除术相比,腹腔镜直肠全系膜切除术在低位直肠癌中疗效更加显著,能够有效缩短患者住院时间与术后下床时间,降低术中出血量、术后总并发症,具有临床应用价值。

Objective To analyze the therapeutic effect of laparoscopic and laparoscopic total mesorectal excision in low rectal cancer. Methods 84 patients with low rectal cancer admitted to our hospital from March 2017 to June 2018 were en-rolled in the study. They were divided into control group and observation group according to different treatment methods. 42 patients in the control group were treated with open-thoracic total mesorectal excision, and 42 patients in the observation group were treated with laparoscopic total mesorectal excision. The hospitalization time, recovery time of intestinal function and treatment effect of the two groups were observed and compared. Results The average hospital stay (18.3±2.6)d and in-testinal function recovery time (4.8±1.6)d were significantly higher than those in the observation group(10.2±4.4)d and (2.2± 1.7)d. The difference was statistically significant (t= 2.67, 2.89, P<0.05). The mean intraoperative blood loss (133.7±17.6)mL and postoperative bedtime (31.5±6.2)h were significantly greater in the control group than in the observation group (85.6± 15.3)mL and (16.8±5.8)h. The difference was statistically significant (t=2.96, 2.88, P<0.05);the incidence of total complica-tion in the control group was significantly higher than that in the observation group (19.04%>2.38%), and the difference was statistically significant (X^2=7.8, P<0.05). Conclusion Compared with open mesorectal excision, laparoscopic total mesorectal excision is more effective in low rectal cancer, which can effectively shorten the length of hospital stay and postoperative bedtime, reduce intraoperative blood loss, and post-surgery complication, with clinical application value.