腹腔镜与开腹全系膜切除术治疗118例直肠癌疗效研究  

Laparoscopic and Open Total Mesorectal Excision for 118 Cases of Colorectal Cancer

作　　者：陆耀[1] 冯国光[1] 顾志相[1] 陈明干[1] 龚庆豪[1] 崔龙[2] 

机构地区：[1]上海交通大学医学院附属新华医院崇明分院普外科,上海202150 [2]上海交通大学医学院附属新华医院普外科,上海202150

出　　处：《现代生物医学进展》2015年第27期5321-5323,共3页Progress in Modern Biomedicine

基　　金：上海市卫生局科研项目(WJ2011314)

摘　　要：目的:探讨开腹与腹腔镜全系膜切除术(TME)治疗直肠癌的疗效及安全性。方法:选择本院收治的直肠癌患者118例,随机分为对照组和观察组,各为59例。对照组行开腹直肠全系膜切除术,观察组行腔镜直肠全系膜切除根治术。比较两组术中效果、淋巴结清扫效果、术后肠道功能恢复、手术风险和随访结果。结果:两组手术时间和淋巴结清扫数目无显著差异(P>0.05);观察组切口长度和术中出血量显著少于对照组(P<0.05),肛门排气、肠胃功能恢复和总住院时间均显著短于对照组(P<0.05);观察组总并发症率为5.08%,显著低于对照16.95%(P<0.05);观察组保肛率达到81.36%,显著高于对照组66.10%(P<0.05);两组2年复发率和转移率间差异无统计学意义(P>0.05)。结论:腹腔镜直肠癌TME创伤小,根治率高,术后恢复快,并发症少,远期疗效与开腹手术相近,综合疗效优于开腹根治术。Objective： To study the efficacy and safety of laparoscopic total mesorectal excision（TME） and open surgery for rectal cancer. Methods： Between January 2011 and January 2014, 118 cases of patients with rectal cancer treated in our hospital were randomly divided into control group and observation group, each of 59 cases. Control group underwent open total mesorectal excision, while observation group had the laparoscopic procedure. Compare the intraoperative situation, the lymph node cleaning effect, recovery of intestinal function, operation risk and follow-up results between the two groups. Results： There was no significant difference between the two groups in operation time and numbers of lymph node cleaned（P〉0.05）. The incision length was significantly shorter and intraoperation blood loss was less in observation group than in control group（P〈0.05）, anal exhaust time, gastrointestinal functional recovery time and the total hospital stay were significantly shorter in observation group than in control group（P〈0.05）. The total complication rate was 5.08% in observation group, significantly lower than in control group（16.95%）（P〈0.05）. The anal preservation rate reached 81.36% in observation group, and 66.10% in control group（P〈0.05）. there was no statistically significant difference between two groups in the rate of recurrence and metastasis within 2 years（P〉0.05）. Conclusion： Laparoscopic TME had small trauma, high cure rate, quicker recovery, fewer complications, similar long-term curative effect but better comprehensive curative effect than open TME.

关 键 词：开腹 腹腔镜 直肠癌 全系膜切除术 

分 类 号：R735.37[医药卫生—肿瘤]