腹腔镜手术治疗中低位直肠癌的疗效分析

Laparoscopic surgery for middle or lower rectal cancer

摘要:

目的 比较腹腔镜与开腹治疗中低位直肠癌的效果。方法 128例中低位直肠癌患者随机分为两组，观察组64例，对照组64例，对照组采用开腹手术治疗，观察组采用腹腔镜治疗。观察两组手术时间、术中出血量、下床活动时间、住院时间、术后并发症、保肛情况和随访期间的复发情况。结果 观察组的术中出血量、下床活动时间、住院时间均明显少于对照组（均P <0.05），两组的手术时间差异无统计学意义（P >0.05）。对照组术后9例患者出现并发症，发生率为14.1%；观察组术后2例患者出现并发症，发生率为3.1%；观察组并发症发生率明显低于对照组（P <0.05）。观察组患者的保肛率明显高于对照组（P <0.05）；随访8～47个月，平均随访（23.1±6.4）个月，两组患者的复发率差异无统计学意义（P >0.05）。结论 腹腔镜直肠癌根治术安全、有效，与开腹手术相比可以减少手术创伤、减少并发症、缩短住院时间和提高保肛率，值得临床推广。

Abstract:

Objective To compare and analyze the effect of laparoscopic surgery and open toperation of rectal cancer in middle or lower positions. Methods 128 patients with middle or lower rectal cancer were randomly divided into observation group and control group, 64 cases in each one, Laparoscopic surgery for observation group and control group using traditional open surgery. Operative time, blood loss, ambulation time, length of stay, postoperative complications, anus-preserving, the recurrence during follow-up were compared between the two groups. Results Blood loss, ambulation time, length of hospital stay, the observation group were significantly less than the control group (P < 0.05), operation time between the two groups have no obvious differences (P > 0.05). Nine patients in control group with complications, the rate was 14.1 %; postoperative complication were observed in 2 cases, the rate was 3.1 %; complication rate in observation group was significantly lower than the control group (P < 0.05). Anus-preserving rate was significantly higher in the observation group (P < 0.05); followed up for 8-47 months with an average follow-up (23.1 ± 6.4) months, relapse rates of the two groups have no significant difference (P > 0.05). Conclusions Compared with open operation，laparoscopic surgery is safe and effective, can reduce the surgical trauma and complications, shorten hospitalization time, improve the anus-preserving rate, worth clinical promotion.