减孔腹腔镜结合悬吊法与传统腹腔镜手术治疗乙状结肠或直肠上段癌的近期疗效对比

Comparison of effectiveness of laparoscopic surgery with reduced orifice and conventional laparo-scopic surgery in the treatment of sigmoid or upper rectal cancer

目的探讨减孔腹腔镜手术治疗乙状结肠及直肠上段癌的安全性及可行性。方法 2018年1月~2019年5月我院收住的乙状结肠或直肠上段癌90例,均行结直肠癌根治术。采用随机数字表法将90例病人随机分成传统腹腔镜手术组与减孔腹腔镜手术组,每组各45例,比较两组病人的术中出血量、手术时间、术后首次排气时间、下床时间、住院时间、住院费用、切除肠管长度、术后并发症发生率、清扫淋巴结数目及疼痛评分等相关指标,评估减孔腹腔镜手术的安全性及可行性。结果减孔腹腔镜组总切口长度与术后疼痛评分分别为(6.9±0.7)cm和(1.9±0.8)分,传统腹腔镜组分别为(9.3±0.7)cm和(2.3±0.6)分,两组比较差异均有统计学意义(P<0.05);两组手术时间、术中出血量、切除肠管长度、术后排气时间、下床活动时间、住院时间、总费用、淋巴结清扫数目、术后并发症发生率、局部复发率、远处转移率及无病生存期比较差异均无统计学意义(P>0.05)。结论减孔腹腔镜结合悬吊法手术治疗乙状结肠癌或直肠上段癌的疗效,与传统腹腔镜手术相当,安全可行。

Objective To investigate the safety and feasibility of laparoscopic surgery with re-duced orifice in the treatment of sigmoid colon and upper rectal cancer.Methods 90 patients with sig-moid colon or upper rectal cancer were recruitedfrom January 2018 to may 2019.The patients were ran-domly assigned to the conventional laparoscopic surgery group and the reduced orifice laparoscopic surgery group,with 45 cases in each group.The preoperative general conditions,intraoperative bloodloss,operation time,exhaust time,out-of-bed activitytime,hospitalizationtime,hospitalizationexpenses,bowel resection length,incidence of complications,number of resected lymph node and postoperative pain score were com-pared.Results The total incision length and postoperative pain score of the two groups were(6.9±0.7)cm and(1.9±0.8),respectively,which were lower than those of the convention laparoscopic surgery group(9.3±0.7)cm and(2.3±0.6),the difference was statistically significant(P<0.05).There was no significant difference in operation time,intraoperative bloodloss,bowel resection length,exhaust time,out-of-bed activitytime,hospitalizationtime,hospitalizationexpenses,number of resected lymph node,inci-dence of postoperative complications,recurrence rate,distant metastasis rateand Disease-free survivalbe-tween the two groups(P>0.05).Conclusion It is safe and feasible to treat sigmoid colon and upper rectal cancer by laparoscopy surgery with reduced orifice.