【摘要】 目的比较腹腔镜辅助与传统开腹直肠癌根治术的疗效。方法对2006年1月至2010年12月170例接受直肠癌根治术患者的临床资料进行回顾性分析。按手术方式分为腔镜组(n=78)、传统开腹组(n=92)。比较两组患者的手术情况、术后并发症、肿瘤根治程度、术后近期及远期疗效等。结果两组患者性别、年龄、BMI、肿瘤距肛缘距离、肿瘤大小、TNM和Dukes分期无显著性差异。腔镜组手术时间(157.4±58.1)分钟,开腹组(145.3±44.2)分钟(P<0.05)。腔镜组术中出血量、切口长度、术后肛门排气时间、进食半流时间、尿管拔除时间、总住院时间均优于开腹组,差异有统计学有意义(均P<0.05)。腹腔镜组手术平均清扫淋巴结(16.7±6.5)枚,开腹组(14.2±5.4)枚,差异有统计学意义(P<0.05)。两组患者手术标本安全切缘及术后并发症发生率比较无显著性差异。腹腔镜组患者满意度及术后疼痛指数均显著优于开腹组(P<0.05)。腔镜组与开腹组的术后2年肿瘤复发率(9.0%vs.10.9%)及生存率(75.6%vs.75.0%)相比,差异无统计学意义(P>0.05)。结论腹腔镜辅助与传统开腹直肠癌根治术患者的预后相当,但腹腔镜辅助手术具有手术创伤小、术后恢复快等优点。更多还原

【Abstract】 Objective To compare clinical outcomes of laparoscopic assisted and traditional open radical operation for rectal cancer patients. Methods Clinical data of 170 rectal cancer patients undergoing laparoscopic-assisted(n =78) and open radical operation(n =92) were analyzed retrospectively. The clinicopathological data including peri-operative parameters, surgical oncologic safety, recurrence and survival were compared between the two groups. Results There were no differences in age, gender, tumor size, BMI, length of tumor lower edge above anal level, TNM and Dukes ’ stages between the two groups(P>0.05). The operation time was(157.4±58.1)min and(145.3±44.2)min respectively in the laparoscopic and open groups(P >0.05). The blood loss, incision length, times of post-operative anal exhaust, taking semi-liquid diet and urethral catheter removal, and hospital stay in the laparoscopic group were significantly better than those in the open group(all P<0.05). The number of lymph nodes harvested was(16.7±6.5) in the laparoscopic group, significantly higher than(14.2 ±5.4) in the open group(P <0.05). There were no differences in saf e resection margin and post-operative morbidity between the two groups. The patients ’satisfaction degree and postoperative pain degree in the laparoscopic group were significantly better than those in the open group. There were no significant difference in 2-year recurrence rate(9.0% vs. 10.9%)and survival rate(75.6% vs. 75.0%) between the laparoscopic and open groups(P >0.05). Conclusions The clinical outcomes of laparoscopic radical resection for rectal cancer patients are similar to conventional open rectal resection. However, laparoscopic assisted radical operation has advantages of little trauma, quick recovery.更多还原