减孔腹腔镜手术治疗直肠癌的近期与远期疗效观察

The Short-term and Long-term Efficacy of Reduction Laparoscopic Surgery for Rectal Cancer

目的探讨减孔腹腔镜手术治疗直肠癌的近期与远期疗效。方法选择80例直肠癌患者,根据随机数字表法,将其分为观察组及对照组,每组40例。对照组给予常规腹腔镜直肠癌根治术,观察组给予减孔(2孔)的腹腔镜直肠癌根治术,对比2组患者的围术期指标、病理学指标、2组中转开腹比例、术后1个月并发症发生率及术后3年无病存活率。结果观察组的手术时间明显较对照组长,但术中出血量、切口长度、肛门排气时间、下床活动时间、住院时间均明显低于对照组(P<0.05)。肿瘤距肛门距离、远切缘距肿瘤下缘距离、淋巴结清扫数目对比,差异无统计学意义(P>0.05)。2组中转开腹及术后并发症发生率对比,差异均无统计学意义(P>0.05)。2组术后3年无病存活率对比,差异无统计学意义(P>0.05)。结论减孔腹腔镜手术与常规腹腔镜手术治疗直肠癌的近远期疗效相当,但减孔腹腔镜手术可缩短患者的术后恢复时间,具有一定优势。

Objective To investigate the short-term and long-term efficacy of reduction laparoscopic surgery for rectal cancer.Methods 80 cases with rectal cancer were selected,and were divided to the observation group and the control group according to the random number table method,the control group was given conventional laparoscopic radical resection of rectal cancer,the observation group were given laparoscopic radical resection of rectal cancer with 2 orifices,the perioperative indicators,pathological indicators,conversion ratio of laparotomy between the 2 groups,the complications incidence at 1 month after surgery and disease-free survival rate at 3 years after surgery of the 2 groups were compared.Results The operation time of the observation group was significantly longer than that of the control group,while the intraoperative blood loss,incision length,anal exhaust time,bed activity time and hospitalization time were significantly lower than that of the control group,P<0.05.There had statistical significance in the distance between the tumor and anus,the distance between the distal resection margin and the lower margin of the tumor,and the number of lymph node dissection between the 2 groups,P>0.05.There had no statistically significant difference in the disease-free survival rate of the 2 groups at 3 years after surgery,P>0.05.Conclusion The short-term and long-term curative effect of laparoscopic surgery for rectal cancer is similar to that of conventional laparoscopic surgery,while the laparoscopic surgery reduction can shorten the postoperative recovery time of patients,and which had certain advantages.