腹腔镜和开腹全直肠系膜切除术治疗中低位直肠癌的疗效比较  

Efficacy of laparoscopic vs.open total mesorectal excision surgery in the treatment of colorectal cancer

作　　者：王耀明[1] 李致文[1] 覃军[1] 黄正有 周腾贤 

机构地区：[1]玉林市红十字会医院普外一区,广西玉林537000

出　　处：《腹部外科》2016年第4期274-277,共4页Journal of Abdominal Surgery

摘　　要：目的分析与探讨腹腔镜全直肠系膜切除术和开腹手术治疗中低位直肠癌的效果及并发症发生情况。方法随机选取2008年3月至2012年10月收治的中低位直肠癌病人80例,将这些病人分为研究组(n=40)和对照组(n=40)。给予对照组病人开腹手术治疗,给予研究组病人腹腔镜全直肠系膜切除术治疗,然后对两组病人的治疗效果及并发症发生率进行统计分析。结果研究组病人的保肛率为67.5%(27/40),显著高于对照组的57.5%(23/40)(P<0.05),术中出血量为(86.1±31.4)ml,显著少于对照组的(120.5±30.8)rnl(P<0.05),手术时间为(178.5±65.2)min,显著长于对照组的(124.1±40.0)min(P<0.05),胃肠道功能恢复时间为(48.3±16.5)h、切口愈合时间为(8.0±1.1)d、术后住院时间为(9.8±4.6)d,均显著短于对照组的(90.6±38.9)h、(12.5±1.0)d和(14.1±6.0)d(P<0.05),复发率为2.5%、死亡率为5.0%,均显著低于对照组的10.0%和15.0%,3年生存率(95.5%)显著高于对照组(75.0%),差异具有统计学意义(P<0.05)。结论腹腔镜全直肠系膜切除术较开腹手术治疗中低位直肠癌具有较好的效果及较低的并发症发生率。Objective To investigate the efficacy and complications of laparoscopic total meso- rectal excision （TME） vs. open surgery in low colorectal cancer. Methods Eighty cases of low color- ectal cancer in our hospital from March 2008 to October 2012 were randomly selected, and divided into study group （n = 40） and control group （n = 40）. The control group was given open surgery, and the study group was given laparoscopic TME. The curative effects and complication rate in the two groups were analyzed. Results Sphincter preservation rate in the study group was 67. 5% （27/40）, signifi- cantly higher than 57. 5% （23/40） （P〈0. 05）, the blood loss was significantly less （P〈0. 05）, the operative time was significantly longer （P〈0. 05）, the recovery time of gastrointestinal function, wound healing time and postoperative hospital stay were significantly shorter （P〈0. 05 for all）, the occurrence rate and mortality were significantly lower, and the 3-year survival rate was significantly higher （P〈0. 05） than in the control group. Conclusions Laparoscopic TME surgery has better re- sults and lower complication rate than open surgery in the treatment of low colorectal cancer.

关 键 词：腹腔镜全直肠系膜切除术 开腹手术 中低位直肠癌 并发症 

分 类 号：R657.1[医药卫生—外科学]