腹腔镜直肠癌根治术与Dixon直肠癌根治术的临床疗效对比  

Efficacy of laparoscopic versus Dixon radical resection for rectal cancer

作　　者：黄甫达[1] 杨昌谋[1] 郭俊宇[1] 浦涧[1] 

机构地区：[1]右江民族医学院附属医院肛肠科,广西壮族自治区百色市533000

出　　处：《世界华人消化杂志》2014年第2期291-295,共5页World Chinese Journal of Digestology

摘　　要：目的:比较腹腔镜与Dixon直肠癌根治术的临床疗效.方法:回顾分析2006-01/2013-01在我院完成腹腔镜直肠癌根治术53例及Dixon直肠癌根治术69例,分析比较两组患者的手术时间、术中出血和术后肛门排气时间、术后并发症及近、远期疗效.结果:与Dixon手术组相比,腹腔镜组直肠癌根治术组手术时间(165.18 min±25.45 min vs177.19 min±12.28 min,P=0.014)、术中出血量(589.85 mL±127.45 mL vs 682.30 mL±122.76 mL,P=0.004)、术后肛门排气时间(3.94 d±1.0 d vs 4.62 d±1.3 d,P=0.01),具有统计学差异,术中摘除淋巴结(3.8±1.6 vs 3.7±1.2,P=0.756)无统计学差异.术后并发症吻合口漏、切口感染、黏连性梗阻发生率低以及性功能和排尿功能满意度高,均有统计学差异(P=0.033,0.049,0.000);但两组肿瘤局部复发远处转移、5年生存率无统计学意义(P=0.701,0.583).结论:腹腔镜直肠癌根治术相比Dixon手术,其手术创伤性小、康复快、术后并发症少及性功能和排尿功能满意度高等优点.但在5年生存率、肿瘤局部复发和远处转移二者无明显差异.AIM： To compare the clinical effects of laparoscopic versus Dixon radical operation for rectal cancer. METHODS： Fifty-three patients who underwent laparoscopic operation and sixty-nine cases who underwent Dixon operation from January 2006 to January 2013 at our hospital were included in this study. The operative time, intraoperative bleeding, postoperative anal exhaust time, and postoperative complications as well as short-term and long-term curative effects were compared between the two groups. RESULTS： Compared with the Dixon operation group, laparoscopic surgery had significantly shorter operative time （165.18 min ± 25.45 min vs 177.19 min ± 12.28 min, P = 0.014）, less intraoperative bleeding volume （589.85 mL ± 127.45 mL vs 682.30 mL ± 122.76 mL, P = 0.004）, and shorter postoperative anal exhaust time （3.94 d ± 1.0 d vs 4.62 d ± 1.3 d, P = 0.01）, while the number of intraoperatively removed lymph nodes （3.8 ± 1.6 vs 3.7 ± 1.2, P = 0.756） did not significantly between the two groups. In addition, the satisfaction to low incidence of postoperative complications, such as anastomotic leakage, wound infection and adhesion obstruction, as well as urinary and sexual functions was significantly higher in the laparoscopic operation group （P = 0.033, 0.049, 0.000）, although there were no statistical differences in local tumor recurrence or distant metastasis and 5-year survival rate between the two groups （P = 0.701, 0.583）. CONCLUSION： Compared with Dixon operation for rectal cancer, laparoscopic surgery was associated with minimal invasion, quicker recovery, fewer postoperative complications and higher satisfaction to sexual and urinary functions, although the 5-year survival rate, local tumor recurrence and distant metastasis showed no significant differences between the two groups.

关 键 词：直肠癌 腹腔镜 DIXON 临床疗效 

分 类 号：R735.37[医药卫生—肿瘤]