摘要
目的:对比分析腹腔镜与开腹手术治疗直肠癌的近期疗效与远期疗效,评价腹腔镜手术的优越性。方法:选取2007年10月至2010年9月接受腹腔镜或开腹手术的直肠癌患者45例,20例行腹腔镜手术(腹腔镜组),25例行开腹手术(开腹组),对比分析两组患者术中出血量、手术时间、术后肠道功能恢复时间、术后并发症及住院时间;采取EORTC QLQ-C30量表评估两组患者术前、术后3 d、术后3个月、术后6个月的生活质量。采用生存分析Kaplan-Meier法对比分析两组患者术后2年生存时间分布情况。结果:腹腔镜组术中出血量、术后肠功能恢复时间及住院时间均明显优于开腹组(P<0.01或P<0.05),手术时间稍长于开腹组(P<0.05),两组并发症发生率差异无统计学意义(P>0.05)。术前两组患者生活质量评价指标差异无统计学意义(P>0.05),术后3 d两组患者生活质量指标出现明显下降(P<0.01),术后3～6个月生活质量指标均有不同程度改善,术后3 d及术后3个月腹腔镜组患者生活质量指标评分均优于开腹组(P<0.05或P<0.01)。术后2年腹腔镜组死亡率较低,死亡患者平均生存时间较长,但与开腹组差异无统计学意义(P>0.05)。结论:腹腔镜直肠癌手术近期疗效确切,手术创伤小,术后康复快,可明显改善患者术后近期生活质量,但远期疗效尚待进一步大样本量的研究证实。
Objective：To compare the short-term and long-term effect of laparoscopic operation and open operation in patients with rectal cancer,in order to evaluate the advantages of laparoscopic operation. Methods：Forty-five patients with rectal cancer undertaking laparoscopy or open operation from Oct. 2007 to Sep. 2010 were enrolled,including 20 cases of laparoscopy operation （ laparoscopy group） and 25 cases of open operation （ open group）. Bleeding volume during operation, operation time, postoperative intestinal function recovery time,postoperative complications and hospital stay were compared between the two groups. EORTC QLQ-C30 scale was adopted to assess quality of life between the two groups preoperatively,in 3 days,3 and 6 months postoperatively. Kaplan-Meier survival dopted to assess quality of life between the two groups preoperatively,in 3 days,3 and 6 months postoperatively. Kaplan-Meier survival analysis was used to compare two groups on two years＇ survival time distributions after operation. Results：The bleeding volume during operation,intestinal function recovery time and hospital stay of laparoscopy group were significantly less than open group （P 〈 0.01 or P 〈 0.05 ）, and operation time was slightly longer than open group （ P 〈 0.05 ）. Two groups＇ complication rate showed no statistically significant difference （ P 〉 O. 05 ）. Preoperative two groups＇ life quality evaluation indexes had no statistically significant differences （ P 〉 O. 05 ） ,in postoperative 3 days two groups＇ life quality indexes decreased significantly （P 〈 0.01 ）, in 3 to 6 months after operation two groups＇ life quality indexes improved in different degrees,in 3 days and 3 months laparoscopy group＇s life quality indicator scores were better than open group （P 〈 O. 05 or P 〈 O. O1 ）. In 2 years after operation, laparoscopy group＇s death ratio was lower, while average survival time of the dead patients was longer than the open group, but had no statistically significan
出处
《腹腔镜外科杂志》
2013年第4期289-292,共4页
Journal of Laparoscopic Surgery
关键词
直肠肿瘤
腹腔镜检查
剖腹术
治疗结果
生活质量
Rectal neoplasms
Laparoscopy
Laparotorny
Treatment outcome
Quality of life
