腹腔镜与开腹直肠癌根治术短期疗效的临床对比  

Clinical comparison of short-term treatment outcomes in laparoscopic and open radical resection of rectal carcinoma

作　　者：李彦良[1] 宋希林[1] 孙现军[1] 于建勇[1] 刘凯[1] 程序瑞[1] 马恒[1] 

机构地区：[1]山东省肿瘤医院,山东济南250117

出　　处：《腹腔镜外科杂志》2010年第6期417-420,共4页Journal of Laparoscopic Surgery

摘　　要：目的:对比分析腹腔镜与开腹直肠癌根治术在直肠癌治疗中的短期临床疗效。方法:回顾分析同一手术组的26例腹腔镜和54例开腹直肠癌根治术的临床资料,并对比两组保肛率、手术相关指标、术后恢复指标、肿瘤根治性指标、住院费用、术后并发症及随访结果。结果:腹腔镜组前12例与开腹组的平均手术时间为212.36min和136.53min(P<0.01),但随着例数的增加腹腔镜组手术时间明显下降,后14例手术时间平均168.73min,与开腹组相比差异无统计学意义(P>0.05)。腹腔镜组术中出血量明显少于开腹组(112.17ml vs.378.33ml,P<0.01),清除的淋巴结数两组差异无统计学意义(12.35枚vs.14.17枚,P>0.05)。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(排气时间2.56d vs.4.67d,P<0.01;进固体饮食时间3.84d vs.4.80d,P<0.01;留置尿管时间3.17d vs.5.87d,P<0.01)。腹腔镜组住院时间明显短于开腹组(8.64dvs.15.38d,P<0.01),住院费用明显高于开腹组(2.97万元vs.2.42万元,P<0.05)。结论:应用腹腔镜技术行直肠癌根治术安全可行,完全可获得与传统开腹手术相似或更优的短期疗效,且具有患者创伤小、出血少、术后康复快等优点。Objective：To compare and analyze the short-term clinical therapeutic effect of laparoscopic and open radical operation for rectal cancer.Methods：Twenty-six laparoscopic and fifty-four open radical operation cases selected from the same surgical group were compared under the following parameters：anus preservation rate,surgical correlated index,postoperative recovery index,tumor radical resection index,hospitalization fee,postoperative complications,and follow-up outcome.The clinical data of patients in two groups were analyzed retrospectively.Results：The mean operation time of first 12 cases in laparoscopic group was 212.36min,and open group was 136.53min（P〈0.01）.But along with the number of laparoscopic cases increased,the operation time tended to decline.The mean operation time of latter fourteen cases was 168.73min.There was 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（112.17ml vs.378.33ml,P〈0.01）.There was no significant difference between the number of cleared lymph node（12.35 vs.14.17,P〉0.05）.The gastrointestinal and urinary function of laparoscopic group recovered more quickly than the open group（exhaust time：2.56d vs.4.67d,P〈0.01;solid food taking time：3.84d vs.4.80d,P〈0.01;detaining urethral catheterization time：3.17d vs.5.87d,P〈0.01）.The hospital stay of the laparoscopic group was shorter than that of the open group（8.64d vs.15.38d,P〈0.01）.But the cost of laparoscopic group was higher than that of the open group（29.7 thousand yuan vs.24.2 thousand yuan,P〈0.05）.Conclusions：Laparoscopic radical resection of rectal carcinoma is safe and feasible.The oncologic resection and short-term effect are comparable between laparoscopic and open surgical approaches.This operation is of much less blood loss during operation,less trauma,similar resection range with the open operation,earlier recovery of function and shorter hospita

关 键 词：直肠肿瘤 腹腔镜检查 剖腹术 短期疗效 对比研究 

分 类 号：R735.37[医药卫生—肿瘤]