【摘要】 目的探讨新辅助化疗后中低位直肠癌的腹腔镜治疗效果。方法选取2014年7月~2015年6月我院收治的100例中低位直肠癌患者,随机分为观察组和对照组各50例,所有患者均行新辅助化疗,对照组在化疗后实施开腹手术,观察组患者在化疗后实施腹腔镜治疗,对比两组患者的手术指标、术后并发症情况。结果观察组手术时间、术中出血量、肛门排气时间、住院时间分别为(209.7±44.2)min、(55.1±5.5)m L、(1.9±0.6)d、(11.4±3.2)d,与对照组的(205.4±39.6)min、(109.4±22.6)m L、(3.5±0.7)d、(12.1±4.0)d相比,术中出血量、肛门排气时间均显著低于对照组(P<0.05);观察组术后并发症发生率为20.0%,显著低于对照组的34.0%(P<0.05);观察组清扫淋巴结数量为(8.7±2.4)枚,对照组清扫数量为(9.1±3.0)枚,两组对比差异无统计学意义(P>0.05);观察组近端切除长度为(13.4±0.6)cm,远端切除长度为(3.0±0.4)cm,对照组近端切除长度为(13.1±0.6)cm,远端切除长度为(2.8±0.3)cm,两组对比差异无统计学意义(P>0.05)。结论中低位直肠癌患者在新辅助化疗后实施腹腔镜手术的近期疗效确切,具有创伤小、恢复快、并发症少的优势,值得在临床上推广应用。更多还原

【Abstract】 Objective To investigate the clinical efficacy of laparoscopic treatment of middle and low rectal cancer after neoadjuvant chemotherapy. Methods 100 patients with middle and low rectal cancer who were admitted in our hospital from July 2014 to June 2015 were selected as the subjects and randomly assigned into observation group and control group with 50 patients in each group. All the patients received neoadjuvant chemotherapy and patients from observation group received laparotomy after the chemotherapy while patients from control group received laparoscopic treatment.Operative indexes and postoperative complications of the patients from both groups were compared. Results The operation time, bleeding amount during the operation, the time of anal exsufflation and hospitalization time of the observation group were respectively(209.7±44.2) min,(55.1±5.5) m L,(1.9±0.6) d and(11.4±3.2) d, while those of the control group were(205.4±39.6) min,(109.4±22.6) m L,(3.5±0.7) d and(12.1±4.0) d. Compared with the control group,observation group had obviously less bleeding amount and shorter time of anal exsufflation(P<0.05); the occurrence of postoperative complications was 20.0%, significantly lower than the 34.0% of the control group(P<0.05); the number of lymph node dissection of the observation group were 8.7 ±2.4 while the number of the control group were 9.1 ±3.0 and there was no significant differences(P >0.05); the length of proximal resection and distal resection of the observation group were respectively 13.4±0.6cm and(3.0±0.4) cm, while the length of the proximal resection and distal resection of the control group were respectively(13.1±0.6) cm and(2.8±0.3) cm and there was no significant difference(P<0.05).Conclusion Laparoscopic surgery have definite short-term clinical efficacy in the treatment of patients with middle and low rectal cancer after neoadjuvant chemotherapy with advantages like small injury, quick recover and less complications, which deserves clinical recommendation and application.更多还原