腹腔镜手术治疗直肠中下段癌55例分析

摘要

Objective To discuss the outcomes and safety of laparoscope-assisted radical surgery for middle and lower rectal carcinoma.Methods Data of 127 patients with middle and lower rectal carcinoma underwent radical surgery were retrospectively analyzed,who were divided into two groups of A(55 cases received laparoscope-assisted surgery) and B(72 cases received conventional open operation).The outcomes and complications were compared.Results The operations were all successful in both groups.Compared to group B,the opearation time was longer[(142.6 ± 28.5) min vs.(166.9 ± 30.7) min] (P＜0.01),but blood loss and the incidence rates of postoperative complication(40.3％ vs.21.8％) and wound infection(13.9％ vs.1.8％) were less in group A (P＜0.05).The postoperative gastrointestinal recovery was earlier and analgesic requirement was less in group A than those in group B(P＜0.01).The surgery-related criteria,the rates of local recurrence and distant matastasis,1-and 3-year survival rates of group A were similar to those of group B (P＞0.05).Conclusion Laparoscope-assisted radical surgery for middle and lower rectal carcinoma can achieve the similar results of conventional open operation with less surgical injury and complications.%目的 探讨腹腔镜直肠癌根治术治疗直肠中下段癌的疗效和安全性.方法 手术治疗直肠中下段癌患者127例分为腹腔镜组(55例)和开腹组(72例),比较手术效果和并发症发生情况.结果 两组手术均获成功.与开腹组比较,腹腔镜组手术时间较长,但术中出血量少、术后并发症发生率和切口感染率显著降低(40.3％ vs.21.8％和13.9％ vs.1.8％)(P＜0.05).腹腔镜组术后通气时间和拔除尿管时间均明显早于开腹组,术后镇痛药应用减少(P＜0.01).两组手术相关指标、术后局部复发和远处转移发生率以及1年和3年生存率相当.结论 腹腔镜直肠癌根治术可以达到与开腹手术相同的肿瘤根治效果和近远期疗效,在术中出血、术后恢复和并发症发生方面优于开腹手术.