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手辅助腹腔镜与开腹直肠癌切除手术疗效对比 被引量:9

Effect compare of laparoscopic and open colorectal surgery
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摘要 目的对比分析手辅助腹腔镜与开腹直肠癌切除手术治疗直肠癌的近期和远期疗效。方法根据术式将2008年7月至2011年7月收治的286例直肠癌患者随机分为两组。观察组患者105例,接受手辅助腹腔镜手术治疗,对照组患者181例,接受开腹手术治疗。术后所有患者均接受至少3年的随访,比较两组术中指标、术后并发症及生存情况。结果 1观察组术中失血量、手术切口长度、术后下床活动时间、术后排气时间、术后进食时间、术后住院时间、术后引流量显著低于对照组,差异有统计学意义(P<0.05)。两组患者淋巴结切除个数相比差异无统计学意义(P>0.05)。2观察组切口感染、肠梗阻等并发症发生率显著低于对照组,差异有统计学意义(P<0.05);两组患者吻合口出血、吻合口漏、乳糜漏、肺部感染等术后并发症发生率相比差异无统计学意义(P>0.05)。3两组患者1年生存率、3年生存率、复发率相比差异均无统计学意义(P>0.05)。结论手辅助腹腔镜手术治疗直肠癌与开腹手术相比具有手术创伤小、术后恢复快、并发症发生率低等优点,远期疗效与开腹手术相当,手辅助腹腔镜手术是治疗直肠癌理想术式。 Objective To compare the early and late clinical effect of laparoscopic and open colorectal surgery in the treatment of colorectal carcinoma. Methods 286 patients with rectal cancer accepted by our hospital in July 2008 to July 2011 were divided into 2 groups according to the treatment methods. 105 cases treated with laparoscopic colorectal surgery were named the observation group,while 181 cases treated with open colorectal surgery were named the control group. After surgery,all the patients received at least 3 years of follow- up. Results ① The surgery bleeding,incision length,postoperative activity time,exhaust time,eating time,hospitalization time and drainage volume of the observation group were lower than those of the control group( P〈0. 05),but there was no significant difference in the number of lymph node excision( P〉0. 05). ② The complication rates of incision infection and intestinal obstruction of the observation group were both lower than those of the control group( P〈0. 05),but there was no significant difference in the other kinds of complication rates,such as anastomotic bleeding,stomal leak,chylous fistula and pulmonary infection( P〉0. 05). ③ There was no significant difference in 1 year survival rate,3 year survival rate and recurrence rate between groups( P〉0. 05). Conclusion Laparoscopic colorectal surgery has smaller trauma and lower complication rate than the open operation,but the forward curative effect of two kinds of operative methods is similar,in a word,laparoscopic surgery is ideal in the treatment of rectal cancer.
作者 袁建军
出处 《临床和实验医学杂志》 2016年第2期149-152,共4页 Journal of Clinical and Experimental Medicine
关键词 直肠癌 手辅助腹腔镜手术 开腹手术 Rectal cancer Hand assisted laparoscopic operation Open operation
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