腹腔镜与开腹Miles术治疗直肠癌远近期疗效的临床对比研究  

CLINICAL COMPARISON OF LAPAROSCOPIC AND OPEN Miles FOR PATIENTS WITH RECTAL CANCER

作　　者：李振军[1] 应晓江[1] 陈洪亮[1] 叶平江[1] 

机构地区：[1]浙江省绍兴市人民医院肛肠科,浙江绍兴312000

出　　处：《河北医科大学学报》2013年第9期1027-1030,共4页Journal of Hebei Medical University

基　　金：浙江省卫生厅医药卫生研究项目(2011KYB125);绍兴市科技计划资助项目(2011A23026)

摘　　要：目的比较腹腔镜与开腹Miles术治疗直肠癌的远近期临床疗效。方法回顾性分析2005年6月一2011年6月由同一手术组完成的109例腹腔镜Miles术和60例开腹Miles术患者的临床资料,比较2组患者的远期生存率、手术情况、术后恢复情况及术后并发症。结果腹腔镜组和开腹组的术中失血量分别为(104±41)mL和(192±82)mL,腹腔镜组显著少于开腹组(P<0.05)。腹腔镜组和开腹组手术时间分别为(191±44)min和(170±34)min,腹腔镜组长于开腹组(P<0.05)。2组淋巴结清扫数目差异无统计学意义。腹腔镜组术后住院时间短于开腹组患者(P<0.05)。开腹组术后切口感染发生机会多于腹腔镜组(P<0.05)。术后3、5年生存率腹腔镜组分别是82.6%%和64.7%,开腹组分别是80.9%和62.9%,2组术后生存率经Life table生存分析差异无统计学意义。结论腹腔镜Miles术远期疗效与开腹手术相似,且具有创伤小、恢复快、并发症少等优势,可以安全应用于直肠癌根治术。Objective To compare the results of laparoscopic and open Miles for patients with rectal cancer. Methods A retrospective analysis was made ＇between 109 cases undergoing laparoscopic Miles and 60 cases undergoing open Miles during the period of June 2005 to June 2011. The long-term survival, operative data, postoperative recovery and complications were compared between two groups. Results The intraoperative blood loss of laparoscopic group was obviously less than that in open group, （104 ±41 ） mL vs （192 ± 82）mL（ P 〈 0. 05 ）. The mean duration of surgery was significantly longer in the laparoscopic group than in the open surgery group, （ 191 ±44） min vs （ 170 ±34）min（P 〈0.05）. No significant difference was observed in the lymph nodes clearance between two groups. Postoperative hospital stay was shorter in laparoscopic group （ P 〈 0.05 ）. The infection of incision was fewer in laparoscopic group than in open group （P 〈 0.05 ）. The 3- and 5-year-survival rate was respectively 82. 6% and 64.7% in laparoscopie group,80.9% and 62.9% in traditional operation group with no significant difference by Life-table method. Conclusion Laparoscopic Miles for rectal cancer can achieve the same long-term effect as conventional laparotomy with minimal invasion, quick recovery and less complications. Laparoscopic Miles can be performed safely for patients with rectal, cancer.

关 键 词：直肠肿瘤 腹腔镜 治疗结果 

分 类 号：R735.37[医药卫生—肿瘤]