腹腔镜与开腹手术根治直肠癌的近远期疗效对比分析  

Comparative Analysis of Short and Long Term Efficacy of Laparoscopic and Open Radical Resection of Rectal Cancer

作　　者：徐振东 XU Zhen-dong(Department of Anorectal,Dandong People’s Hospital,Liaoning Province,Liaoning Dandong 118000)

机构地区：[1]辽宁省丹东市人民医院肛肠科,辽宁丹东118000

出　　处：《中国医疗器械信息》2023年第4期61-63,共3页China Medical Device Information

摘　　要：目的:分析直肠癌疾病特点,比较腹腔镜与开腹手术根治直肠癌的近远期疗效。方法:将2016年1月~2017年12月150例行直肠癌根治术的患者按手术方法分为腹腔镜组和开腹组,每组75例,医院伦理委员会审核批准。比较经不同术式治疗后,两组直肠癌患者围术期指标、远期生存情况。结果:组间手术相关指标方面,腹腔镜组患者平均术中出血量、肠鸣音恢复时间、肛门排气时间及术后1d疼痛评分均明显少(低)于开腹组(P<0.05),疼痛状况以视觉模拟评分法(Visual Analogue Scale/Score,VAS)评估。组间清扫淋巴结数目无明显差异(P>0.05);组间远期生存情况方面,腹腔镜组患者中位无进展生存时间为8.13个月(2.9~17.6个月),中位总生存时间为13.4个月(4.7~25.1个月);开腹组患者中位无进展生存时间为7.75个月(3.5~19.3个月),中位总生存时间为13.9个月(4.4~24.8个月),两组比较无明显差异(P>0.05)。结论:腹腔镜直肠癌根治术能够达到与传统开腹手术相似的淋巴结清扫数目和生存情况,而它能够显著减少术中出血量、手术损伤,促进患者术后更快恢复,是有效术式。Objective:To analyze the characteristics of rectal cancer,and to compare the short-and long-term curative effects of laparoscopic and open surgery in radical treatment of rectal cancer.Methods:From January 2016 to December 2017,150 patients who underwent radical resection of rectal cancer were divided into laparoscopic group and laparotomy group according to the surgical method,75 cases in each group,reviewed and approved by the hospital ethics committee.After different surgical treatments,the perioperative indicators and long-term survival of the two groups of rectal cancer patients were compared.Results:In terms of surgical indicators between the groups,the average intraoperative blood loss,bowel sound recovery time,anal exhaust time,and pain score 1 day after surgery in the laparoscopic group were significantly less(lower)than the open group(P<0.05),the pain status was evaluated by Visual Analogue Scale/Score(VAS).There was no significant difference in the number of lymph nodes dissected between the groups(P>0.05);In terms of long-term survival between the groups,the median progression-free survival time of patients in the laparoscopic group was 8.13 months(2.9-17.6 months),and the median overall survival time was 13.4 months(4.7-25.1 months);The median progression-free survival time of patients in the open group was 7.75 months(3.5-19.3 months),and the median overall survival time was 13.9 months(4.4-24.8 months).There was no significant difference between the two groups(P>0.05).Conclusion:Laparoscopic radical resection of rectal cancer can achieve similar number of lymph node dissections and survival conditions as traditional open surgery,and it can significantly reduce intraoperative blood loss,surgical damage,and promote faster recovery of patients after surgery.It is an effective operation.

关 键 词：腹腔镜 开腹手术 直肠癌根治术 手术情况 恢复情况 远期生存情况 

分 类 号：R687.3[医药卫生—骨科学]