【摘要】 目的 探讨腹腔镜下全直肠系膜切除术(TME)联合新辅助治疗在中低位直肠癌的近期疗效。方法 将广东省高州市人民医院201 1年1月至2013年12月收治的84例中低位直肠癌患者按随机数字表随机分为观察组与对照组,每组42例。2组患者均进行新辅助治疗,放化疗结束6~8周后进行手术,观察组行腹腔镜下TME手术,对照组行开腹手术,比较2组患者的术后恢复情况、手术切除肿瘤学指标。结果 观察组术后排气时间明显低于对照组[(40±13)h比(61±15)h)],术后恢复流质饮食时间明显短于对照组[(50±14)h比(67±13)h],术后恢复正常饮食时间明显短于对照组[(85±10)h比(95±13)h)],术后排便时间明显短于对照组[(94±16)h比(119±17)h],住院时间明显短于对照组(中位时间:10 d比13 d),肺部感染发生率明显低于对照组[2.4%(1/42)比14.3%(6/42)],差异均有统计学意义(均P<0.05),手术切除肿瘤学的相关指标,如肿瘤大小、清扫淋巴结数目、肿瘤分化情况、ypT分型、近端切除范围、远端切除范围、径向切除范围、环周切缘情况、全直肠系膜切除标本切除的完整性2组比较差异均无统计学意义(均P>0.05)。结论 中低位直肠癌新辅助治疗后腹腔镜下TE手术与开腹手术切除肿瘤效果相当,腹腔镜下TME手术安全、可行,具有更短的术后排气时间、饮食恢复时间、排便时间及住院时间。更多还原

【Abstract】 Objective To explore the short term efficacy of total mesorectal excision(TME) laparoscopic surgery combined with neoadjuvant therapy for the treatment of low rectal cancer.Methods Totally 84 patients with low rectal cancer were randomly and equally divided into observation group and control group.All patients underwent neoadjuvant therapy;the surgery was performed 6-8 weeks after chemotherapy.The observation group underwent TME laparoscopic surgery and the control group underwent open colectomy.The recovery and surgical removal of the tumor markers were compared.Results Exhaust time in the observation group was significantly lower than in the control group[(40±13)h vs(61 ±15) h)];liquid diet recovery time was significantly shorter than that in the control group[(50±14)h vs(67±13)h];postoperative recovery of normal diet was significantly shorter than that in the control group[(85±10)hvs(95±13)h)];defecation was significantly lower than that in the control group[(94±16)hvs(119 ± 17)h];the length of hospital stay was significantly shorter than that in the control group(median time;10 d vs.13 d);the incidence of lung infection was significantly lower than that in the control group[2.4%(1/42) vs 14.3%(6/42)](all P<0.05).The oncology-related indicators of surgical resection including tumor size,number of lymph nodes,tumor differentiation,ypT type,proximal resection,resection of the distal radial extent,circumferential resection margin status and TME complete resection specimens showed no statistical difference between the two groups(P>0.05).Conclusions TME laparoscopic surgery and open surgeiy in the treatment of low rectal cancer is effective.TME laparoscopic surgery is feasible with a short postoperative exhaust time,diet recovery time,postoperative defecation and length of hospitalization.更多还原