直肠癌新辅助放化疗后采用3D与2D腹腔镜手术治疗的效果对比

Comparison of laparoscopic surgery with 3D and 2D after neoadjuvant radiochemotherapy for rectal cancer

目的 :对比分析直肠癌新辅助放化疗后采用3D与2D腹腔镜手术治疗的效果。方法 :回顾性收集2016年1月~2017年6月我院收治的176例直肠癌患者作为研究对象,根据手术方法分为3D组80例与2D组96例,两组患者均采用新辅助放化疗,放化疗完成后6~8周接受腹腔镜手术治疗,3D组采用3D腹腔镜系统,2D组采用2D腹腔镜系统,比较两组患者手术相关指标、术后近期并发症、远期排尿功能及性功能的相关情况。结果 :3D组的手术时间、术中出血量显著少于2D组,差异有统计学意义;3D组与2D组的淋巴结清扫数、术后排气时间及住院时间均无统计学差异。3D组的并发症发生率显著低于2D组,差异有统计学意义。3D组远期勃起功能障碍、远期射精功能障碍的发生率低于2D组,差异有统计学意义。结论 :直肠癌新辅助放化疗后采用3D腹腔镜比传统2D腹腔镜的手术时间更短,并且能够有效减少术中出血量及术后并发症、远期性功能障碍的发生。

Objective To compare the effect of laparoscopic surgery with 3D and 2D after neoadjuvant chemoradiotherapy for rectal cancer. Methods Methods a retrospective study was conducted on 176 patients with rectal cancer who were treated in our hospital from January 2016 to June 2017, According to the operation method, 80 cases were divided into 3D group and 96 cases in 2D group, Two groups of patients were treated with neoadjuvant chemoradiotherapy, after 6~8 weeks, they underwent laparoscopic surgery, 3D group used 3D laparoscopic system, 2D group used 2D laparoscopic system. The operation related indexes, postoperative short-term complications, long-term urination function and sexual function were compared between the two groups. Results The operation time and the amount of bleeding during operation in 3D group were significantly less than those in 2D group, the difference was statistically significant; There was no statistical difference between 3D group and 2D group of lymph nodes, postoperative exhaust time and hospitalization time. The complication rate of 3D group was significantly lower than that of 2D group, the difference was statistically significant. The incidence of long-term erectile dysfunction and long-term ejaculatory dysfunction in group 3D was lower than that in group 2D, the difference was statistically significant. Conclusion The operation time in 3D laparoscopic surgery for rectal cancer after neoadjuvant chemoradiotherapy is shorter than that in traditional 2D laparoscopy, And can effectively reduce the amount of bleeding during surgery and postoperative complications, longterm sexual dysfunction.