摘要
目的:观察腹腔镜直肠根治术与开腹直肠癌根治术治疗直肠癌的近期疗效对比.方法:对76例直肠癌患者进行不同手术方案的临床分组,其中38例手术方案为腹腔镜直肠根治术(观察组),38例手术方案为开腹直肠癌根治术(对照组).对两组患者近期疗效(淋巴结清除数,术中、术后并发症、手术时间、术中出血量、肠蠕动恢复时间、下床活动时间、住院时间)等进行观察比较.此外,对患者进行为期1年的跟踪随访,观察两组患者的近期复发率、生存率.结果:两组手术患者术程中均顺利,术后并发症方面,观察组在减低切口感染(0例)、炎性肠梗阻(0例)以及并发症总例数(10例)等均显著优于对照组(5、5、22例)(P<0.05).观察组淋巴结清除数(19.7个±5.5个)、手术时间(139.8 min±39.8 min)、术中出血量(131.1m L±59.3 m L)、肠蠕动恢复时间(48.9 h±11.6 h)、下床活动时间(59.7 h±10 h)、住院时间(8.4 d±3.8 d)等观察指标明显优于对照的(17.4个±4.1个)、(140.6 min±35.5 min)、(123.3 mL±72.0 mL)、(57.1 h±12 h)、(70.2h±15.4 h)、(11.2 d±2.8 d)差异有统计学意义(P<0.05).3、6 mo肿瘤复发率及生存率两组未见明显差异(P>0.05),1年死亡率比较,观察组为5.26%,低于对照组的21.05%(P<0.05).结论:腹腔镜直肠根治术治疗直肠癌的疗效确切,能够提高近期疗效,减少术后并发症的发生,同时提高患者1年生存率,减少复发率.
AIM： To compare the short-term effects of lapa- roscopic radical resection versus traditional laparotomy in the management of rectal cancer. METHODS： Seventy-six patients with rectal cancer who underwent radical resection were included in this study, of whom 38 underwent laparoscopic radical resection （observation group） and 38 underwent traditional laparoto- my （control group）. Short-term effects （number of resected lymph nodes, intraoperative, post- . b operative complications, operative time, blood loss, time to peristalsis recovery, time to ambu- lation, and length of stay） were observed and compared between the two groups. In addition, the patients were followed for I year to observe recurrence and survival.RESULTS： The incidences of postoperative wound infection, inflammatory intestinal ob- struction and overall complications were bet- ter in the observation group （all P 〈 0.05）. The number of resected lymph nodes （19.7 ± 5.5 vs 17.4 ± 4.1）, operative time （139.8 rain ± 39.8 rain vs 140.6 min ± 35.5 min）, blood loss （131.1 mL ± 59.3 mL vs 123.3 mL ± 72.0 mL）, time to peri- stalsis recovery （48.9 h ±11.6 h vs 57.1 h ± 12 h）, time to ambulation （59.7 h ± 10.9 h vs 70.2 h ± 15.4 h）, and length of stay （8.4 d ± 3.8 d vs 11.2 d ± 2.8 d） were also better in the observation group （all P 〈 0.05）. Tumor recurrence and survival at 3 and 6 months had no significant differences between the two groups （P 〉 0.05）; however, the 1-year mortality rate was significantly lower in the observation group than in the control group （5.26% vs 21.05%, P 〈 0.05）. CONCLUSION： Laparoscopic radical resection is superior to traditional laparotomy in the man- agement of rectal cancer in terms of improving short-term efficacy and survival and reducing the incidence of postoperative complications and recurrence.
出处
《世界华人消化杂志》
CAS
北大核心
2013年第24期2475-2479,共5页
World Chinese Journal of Digestology
