【摘要】 目的 探讨腹腔镜辅助直肠癌根治术近期临床结局及五年生存率。方法 根据术式不同将西安交通大学第二附属医院2015年4月至2017年4月收治的120例直肠癌分为两组，行腹腔镜辅助直肠癌根治术患者为腹腔镜组，行传统开腹手术患者为开腹组，每组各60例。比较两组患者近期临床结局及五年生存率，同时采用Cox回归模型分析患者预后影响因素。结果 两组皮肤切口长度、肠功能恢复时间、术后固体进食时间、术后住院时间、术中出血量、并发症发生率、术后五年生存率比较，差异有统计学意义（P <0.05）；脉管侵犯（有）、CEA（≥5 ng/ml）、肿瘤类型（浸润型）、分化程度（低分化）、TNM分期（Ⅲ期）是患者预后生存的独立危险因素（P <0.05）。结论 腹腔镜辅助直肠癌根治术与传统开腹手术相比近期疗效相当，但前者在手术创伤、术后恢复及安全性方面更具优势，且远期预后更佳。更多还原

【Abstract】 Objective To investigate the short-term clinical outcome and 5-year survival rate of laparoscopicassisted radical resection of rectal cancer. Methods A total of 120 cases of rectal cancer admitted to and treated in the Second Affiliated Hospital of Xi’an Jiaotong University from April 2015 to April 2017 were divided into the laparoscopic group(n=60) and the laparotomy group(n=60) according to different surgical procedures. Patients in the laparoscopic group were treated with laparoscopic-assisted radical resection of rectal cancer, while those in the laparotomy group were treated with conventional laparotomy surgery. The short-term clinical outcome and 5-year survival rate of the two groups of patients were compared, and the impacting factors of prognosis were analyzed by Cox regression model. Results There were statistically significant differences in the length of skin incision, recovery time of intestinal function, postoperative solid food intake time, postoperative hospitalization time, intraoperative hemorrhage volume,incidence of complications and postoperative 5-year survival rate between the two groups(P < 0.05). Vascular invasion(positive), CEA( ≥ 5 ng/ml), tumor type(invasive type), degree of differentiation(poorly differentiated)and TNM stages(stage Ⅲ) were independent risk factors for the prognosis and survival of patients(P < 0.05).Conclusion Compared with conventional laparotomy surgery, laparoscopic-assisted radical resection of rectal cancer has the same short-term efficacy, but laparoscopic-assisted radical resection of rectal cancer has more advantages in terms of surgical trauma, postoperative recovery and safety, and has a superior long-term prognosis.更多还原