【摘要】 目的比较进展期直肠癌短程放疗后行腹腔镜手术与开腹根治术的临床效果。方法选择我院2009年2月至2012年1月收治的78例进展期直肠癌患者,按就诊及入院顺序编号,均分为观察组与对照组两组,各39例。两组术前均给予短程放疗,对照组放疗后采用开腹根治术,观察组放疗后采用腹腔镜手术治疗,观察两组治疗效果,比较两组手术时间、术中出血量、淋巴结清扫数目、术后肛门排气时间、住院时间,评估术后肛门括约肌功能,统计并发症发生率,两组均随访3年,统计总生存率、肿瘤复发及转移率。结果 1观察组总缓解率84.62%,对照组总缓解率82.05%,两组总缓解率对比差异无统计学意义(P>0.05)。2两组手术时间、淋巴结清扫数目相近(P>0.05),观察组术中出血量少于对照组,术后肛门排气时间、住院时间短于对照组,对比差异有统计学意义(P<0.05)。3观察组并发症发生率为12.82%,低于对照组的43.59%(P<0.05)。4观察组括约肌功能恢复良好率稍高于对照组,但对比差异无统计学意义(P>0.05)。5随访2年,两组总生存率、转移率对比差异无统计学意义(P>0.05),观察组复发率略低于对照组,但对比差异无统计学意义(P>0.05)。结论短程放疗联合腹腔镜手术治疗进展期直肠癌,对患者机体创伤小,术后并发症发生率低,远期生存质量好。更多还原

【Abstract】 Objective To compare the clinical effects of laparoscopic and open radical operation in the treatment of advanced rectal cancer after short-course radiotherapy. Methods 78 cases of patients with advanced rectal cancer who were treated in our hospital between February 2009 and January 2012 were numbered according to the order of treatment and admission, and were randomized into the observation group and the control group, 39 cases in each. Before operation, both of the two groups were treated with short course radiotherapy. The control group was treated with open radical operation after radiotherapy while the observation group was treated with laparoscopic operation. The curative effects,the operation time, intraoperative bleeding volume, number of lymph node dissection, postoperative anal exhaust time and hospitalization time were compared between the two groups. The postoperative anal sphincter function was evaluated. The incidence of complications was statistically analyzed. The two groups were followed up for 3 years. The total survival rate, tumor recurrence and metastasis rate were also statistically analyzed. Results 1The total remission rate in the observation group was 84.62% while in the control group was 82.05%(P >0.05). 2The operation time and number of lymph node dissection were similar in the two groups(P >0.05). The intraoperative bleeding volume of the observation group was less than that of the control group. The postoperative anal exhaust time and hospitalization time was shorter than that of the control group(P<0.05). 3 The incidence of complications in the observation group(12.82%) was lower than that in the control group(43.59%)(P <0.05). 4The excellent and good rate of anal sphincter function recovery in the observation group was slightly higher than that in the control group(P >0.05). 5In 2 years of follow-up, there was no significant difference in the total survival rate and metastasis rate between the two groups(P >0.05). The recurrence rate in the observation group was slightly lower than that in the control group(P >0.05). Conclusion Short-course radiotherapy combined with laparoscopic operation in the treatment of advanced rectal cancer does little damage to the body. The incidence of postoperative complications is low and long-term survival quality is good.更多还原