腹腔镜下直肠癌根治术的近期临床疗效观察

Short-term clinical efficacy observation of laparoscopic radical resection for rectal cancer

摘要:

目的 探讨腹腔镜下直肠癌根治术的近期临床疗效。方法 回顾性分析2015 年11 月-2016 年11 月该院行直肠癌根治性手术的患者50 例。其中，行腹腔镜下直肠癌根治术的患者27 例，行开腹直肠癌根治 术的患者23 例，观察两组患者手术时间、肿瘤直径、标本切除长度、术中清扫淋巴结数目、开始下床活动时 间、术后肛门排气时间、术后的排便时间、术后开始进食时间和术后并发症等指标。结果 腹腔镜组患者的 肿瘤直径、标本切除长度和淋巴结清扫数目为（3.8±1.4）cm、（18.5±2.1）cm 和（7.2±3.1）枚，而开腹组 患者相应检查项目分别为（3.9±1.4）cm、（18.6±2.3）cm 和（7.7±3.4）枚，组间比较差异不具统计学意义 （P >0.05）。腹腔镜组患者在术中出血量、手术时间、术后下床活动时间、术后肛门排气时间、术后排便时间、 术后进食流质食物时间和术后住院时间分别为（105.3±23.8）ml、（140.2±22.3）min、（4.0±1.2）d、（6.0±1.5）d、 （3.0±1.0）d、（3.5±0.5）d 和（4.0±1.0）d， 开腹组相应数值为（210.4±21.3）ml、（118.9±20.7）min、 （4.5±1.1）d、（7.8±1.2）d、（7.0±1.6）d、（8.1±2.0）d 和（10.0±3.2）d，两组患者的比较差异有统计学意 义（P <0.05）。结论 腹腔镜下直肠癌根治性手术安全有效，可以对肿瘤做到根治性切除，且术中出血少，术 后康复快，住院时间短。

Abstract:

Objective To discuss the short-term clinical curative effect of laparoscopic colorectal cancer radical resection for rectal cancer. Methods Clinical data of 50 patients with rectal cancer underwent radical resection from November 2015 to November 2016 were retrospectively analyzed. Among them, 27 cases underwent laparoscopic radical resection (Laparoscopy group), the other 23 cases underwent radical resection (Laparotomy group). Then observe and record the operation time, tumor diameter, specimen length, number of lymph node cleaning, time of ambulation, postoperative anal exhaust time, postoperative defecation time, postoperative complications and postoperative eating time of the two groups. Results The tumor diameter, length of specimens and number of lymph node dissection in laparoscopic group were (3.8 ± 1.4) cm, (18.5 ± 2.1) cm and (7.2 ± 3.1), while in Laparotomy group were (3.9 ± 1.4) cm, (18.6 ± 2.3) cm, and (7.7 ± 3.4), the difference has no statistical significance (P > 0.05). The intraoperative blood loss, operation time, ambulation time, postoperative anal exhaust time, postoperative defecation time, postoperative eating liquid diet time, postoperative hospitalization time in laparoscopic group were (105.3 ± 23.8) ml, (140.2 ± 22.3) min, (4.0 ± 1.2) d, (6.0 ± 1.5) d, (3.0 ± 1.0) d, (3.5 ± 0.5) d and (4.0 ± 1.0) d, while in Laparotomy group were (210.4 ± 21.3) ml, (118.9 ± 20.7) min, (4.5 ± 1.1) d, (7.8 ± 1.2) d, (7.0 ± 1.6) d, (8.1 ± 2.0) d and (10.0 ± 3.2) d, there was significant difference between the two groups (P < 0.05). Conclusion Laparoscopicsurgery for rectal cancer is safe and effective. It can achieve radical tumor resection, and intraoperative less bleeding, faster postoperative recovery, shorter hospitalization time.