腹腔镜与开腹全直肠系膜切除术治疗Ⅱ、Ⅲ期直肠癌临床疗效比较  

Clinical comparison of laparoscopic and open total mesorectal for stage Ⅱ or Ⅲ rectal cancer

作　　者：周才进[1] 许庆文[1] 欧雯婷[1] 徐飞鹏[1] 林琳[1] 黄哲[1] 

机构地区：[1]广东医学院附属医院胃肠外科,广东省湛江市524001

出　　处：《实用医学杂志》2017年第17期2850-2852,共3页The Journal of Practical Medicine

基　　金：卫生部医药卫生科技发展研究中心课题项目(编号:W2013R07)

摘　　要：目的比较腹腔镜和开腹全直肠系膜切除术对Ⅱ、Ⅲ期直肠癌患者的安全性及近期临床疗效的影响。方法将2014年6月至2016年6月在我院确诊为直肠癌的106例患者随机分为2组,腹腔镜组(n=53)及开腹组(n=53),比较两组患者的手术时间、出血量、切口总长度、远切缘长度、近切缘长度、获取淋巴结个数、切缘残癌率、术后肛门首次排气时间、首次下床活动时间、住院时间等情况。结果腹腔镜组出血量、切口长度、住院时间、术后排气时间及术后首次下床活动时间等指标均优于开腹组,两组比较差异均有统计学意义(P<0.05);而腹腔镜组手术时间、远切缘长度、近切缘长度、获取淋巴结个数及切缘残癌率与开腹组比较,差异无统计学意义(P>0.05)。结论腹腔镜全直肠系膜切除治疗Ⅱ、Ⅲ期直肠癌安全可行,具有患者创伤小、康复快、住院时间短的等优点;并可取得与开腹直肠癌根治术的同样效果。Objective To observe and compare the safety and short-term outcomes of laparoscopic surgery （LS） versus conventional open surgery （OS） for stage Ⅱ or Ⅲ rectal cancer （RC）. Methods One hundred and six patients with stage Ⅱ or Ⅲ RC were divided into LS group （n = 53） and OS group （n = 53） according to the random double blind method. The related outcomes of two groups were compared, including surgical duration, intraoperative blood loss, length of incision, distal margin length, proximal margin length, the number of lymph node dissection, residual cancer rate, exhaust time, first ambulation time, and postoperative hospital stay. Results Intraoperative blood loss, length of incision, postoperative hospital stay, exhaust time and the first ambulation time in LS group were significantly different from those in OS group （P 〈 0.05 for all comparisons ）. And there were no significant differences between the two groups in surgical duration, the number of lymph node dissection, distal margin length, proximal margin length and residual cancer rate （P 〉 0.05）. Conclusions Laparoscopic technology is safe and feasible in treating rectal carcinoma, with less trauma, quicker recovery, and shorter hospital stay.

关 键 词：直肠癌 腹腔镜技术 

分 类 号：R735.37[医药卫生—肿瘤]