腹腔镜与开腹直肠癌根治术临床疗效对比分析  

Clinical efficacy comparison of laparoscopic radical resection and open radical resection on rectal cancer

作　　者：安兆峰[1] 刘清泉[1] 张义伟[1] 

机构地区：[1]河南省漯河市中心医院普外二科,462000

出　　处：《中国实用医刊》2016年第22期58-60,共3页Chinese Journal of Practical Medicine

摘　　要：目的：对比分析腹腔镜与开腹直肠癌根治术的临床疗效，探讨腹腔镜手术的优势和可行性。方法回顾性分析直肠癌手术患者的临床资料，开腹根治性手术86例，成功实施腹腔镜直肠癌根治术32例，对比两组患者手术时间、术中出血量、清扫淋巴结数目、术后肛门排气时间、留置尿管时间、术后住院时间及并发症发生率等指标。结果腹腔镜组手术时间[（236.7±35.7）min]明显长于开腹手术组[（174.5±29.6）min]（P〈0.05）；腹腔镜组术中出血量[（100.3±19.7）ml]较开腹手术组[（167.3±25.6）ml]明显减少（P〈0.05）；两组患者术中淋巴结清扫数目比较，差异未见统计学意义（P〉0.05）。腹腔镜组术后肛门排气时间、留置尿管时间及术后住院时间明显短于开腹手术组，差异有统计学意义（P〈0.05）。两组术后并发症发生率比较，差异未见统计学意义（P〉0.05）。结论腹腔镜直肠癌手术是安全、有效、可行的，值得临床推广应用。Objective To analyze the clinical efficacy of laparoscopic radical resection and open radical resection on rectal cancer,and investigate the feasibility and advantage of laparoscopic surgery. Methods The clinical data of patients with rectal cancer underwent surgical treatment were retrospec-tively analyzed,86 cases treated by open surgery,and another 32 cases successful implemented with lap-aroscopic radical resection. The intraoperative and postoperative indexes including operative time,blood loss,number of lymph nodes,postoperative anal exhaust time,indwelling catheter time,postoperative hospital stay and complication rate were compared. Results The operation time in the laparoscopic sur-gery group[（236. 7 ±35. 7）min]was longer than that in the open surgery group[（174. 5 ± 29. 6）min], （P〈 0. 05）. The introperative bleeding volume in the laparoscopic surgery group[（100. 3 ± 19. 7）ml] was less than that in the open surgery group[（167. 3 ± 25. 6）ml]（P〈 0. 05）. There was no significant difference in the number of lymph nodes dissection during operation between the two groups（P〉 0. 05）. The postoperative anal exhaust time,indwelling urinary catheter time and postoperative hospitalization time were shorter than that in the open surgery group（P〈 0. 05）. There was no significant difference in the postoperative complication rate between the two groups（P〉 0. 05）. Conclusions Laparoscopic sur-gery for rectal cancer is safe,effective and feasible,and is worthy clinical application.

关 键 词：直肠癌 腹腔镜 全直肠系膜切除术 

分 类 号：R735.37[医药卫生—肿瘤]