腹腔镜直肠癌根治术与开腹直肠癌根治术的临床对比  

Comparison of laparoscopic and openradical by resection of rectal carcinoma

作　　者：金红旭[1] 张雪峰[1] 李瑾[1] 吴国强[1] 王希泽[1] 舒爱英[2] 曲化远[1] 宗修锟[1] 

机构地区：[1]沈阳军区总医院普通外科,110016 [2]沈阳市苏家屯区中心医院普通外科

出　　处：《消化外科》2005年第1期10-13,共4页Journal of Digestive Surgery

摘　　要：目的　探讨应用腹腔镜技术行直肠癌根治术的可行性及近期临床疗效。方法　选择2 0 0 3年 2月至 2 0 0 4年 8月我科行腹腔镜直肠癌根治术 2 4例 (Dixon手术 15例、Miles手术 9例 ) ,开腹直肠癌根治术患者 30例 (Dixon手术 2 2例、Miles手术 8例 ) ,对照研究两组病人手术及术后情况。结果　腹腔镜组与开腹组的平均手术时间为 2 0 1.4 6min和 15 6 .33min ,有显著差异 (P <0 .0 1) ,但随着例数的增加腹腔镜手术的时间呈明显下降趋势 ,后 12例病人的平均手术时间为 172 .92min ,与开腹组比较无显著差异 (P >0 .0 5 )。腹腔镜组术中失血量明显少于开腹组 (12 9.17mlvs393.33ml,P <0 .0 1) ,清除的淋巴结数量无显著差异 (11.75枚vs13.2 7枚 ,P >0 .0 5 )。腹腔镜组术后胃肠功能和排尿功能恢复时间明显早于开腹组 (排气、进流食时间 2 .4 6dvs3.6 7d ,P <0 .0 1;进固体饮食时间 3.5 4dvs4 .70d ,P <0 .0 1;留置导尿时间 4 .17dvs5 .97d ,P <0 .0 1)。腹腔镜组住院时间明显短于开腹组(9.5 4dvs12 .97d ,P <0 .0 1) ,住院费用仍明显高于开腹组 (2 .2 7万元vs1.92万元 ,P <0 .0 5 )。结论　应用腹腔镜技术行直肠癌根治术安全可行 ,切除范围能够达到开腹手术的水平 ,且具有创伤小、出血少、术后恢复快等特点 ,极具?Objective To study the feasibility and curative effect of laparoscopic radical resection of rectal carcinoma. Methods Fifty four cases were chosen who underwent radical resection of rectal carcinoma in our department from Feb. 2003 to Aug. 2004. Twenty four cases underwent laparoscopic radical resection of rectal carcinoma (fifteen cases underwent Dixon and nine cases underwent Miles), and the other thirty cases underwent open radical resection of rectal carcinoma (twenty two cases underwent Dixon and eight cases underwent Miles). The clinical data of patients in two groups were compared. Results The mean operation time of laparoscopic group was 201.46 min, and open group was 156.33 min. There is significant difference (P<0.01). But along with number of the laparoscopic cases increased, the operation time tended to decline. The mean operation time of latter twelve cases was 172.92 min. There is no significant difference compared with that of the open group (P>0.05). The intra operative blood loss of the laparoscopic group was obviously less than that of the open group (129.17 ml vs 393.33 ml, P<0.01). There was no significant difference between the number of cleared lymphaden (11.75 pieces vs 13.27 pieces, P>0.05). The gastrointestinal and urinary function of laparoscopic group recovered quickly than the open group. The hospitalization stay of the laparoscopic group was shorter than that of the open group (9.54 day vs 12.97 day, P<0.01). But the cost of laparoscopic group was higher than that of the open group (22.7 thousand yuan vs 19.2 thousand yuan, P<0.05). Conclusions Laparoscopic radical resection of rectal carcinoma is feasible and minimally invasive. This operation has much lower blood loss during operation similar resection range of the open operation, earlier recovery of function and shorter hospitalization.

关 键 词：腹腔镜 直肠肿瘤 手术 

分 类 号：R735.37[医药卫生—肿瘤]