腹腔镜下低位直肠癌根治术与传统开腹手术的疗效与安全性比较  

Comparison of efficacy and safety between laparoscopic radical resection of low rectal cancer and traditional open surgery

作　　者：朱琪[1] 吴颖霞[1] 项洪刚 ZHU Qi;WU Ying-xia;XIANG Hong-gang(Department of General Surgery,Shanghai Pudong New Area People's Hospital,Shanghai 201299,China.)

机构地区：[1]上海市浦东新区人民医院普外科,上海201299

出　　处：《中国处方药》2024年第4期178-181,共4页Journal of China Prescription Drug

基　　金：上海市浦东新区卫生系统重点专科建设项目(PWZzk2022-09)。

摘　　要：目的观察腹腔镜下低位直肠癌根治术与常规开腹直肠癌根治术的近期疗效和安全性。方法选取2021年4月~2023年4月收治的80例低位直肠癌患者,采用随机数字表法分为观察组和对照组,各40例。观察组行腹腔镜下低位直肠癌根治术,对照组行常规开腹直肠癌根治术。比较两组围术期指标、环周切缘状态和保肛率、术后恢复情况、血清炎症因子水平及术后并发症发生率。结果两组手术时间、淋巴结清扫数目差异无统计学意义(P>0.05);观察组与对照组术中出血量分别为(90.24±23.34)ml、(148.02±18.67)ml,切口长度分别为(5.17±0.94)cm、(14.75±2.26)cm,观察组术中出血量少于对照组,切口长度短于对照组(P<0.05);两组患者手术后环周切缘阳性率和保肛率差异无统计学意义(P>0.05);观察组与对照组术后肛门首次排气时间分别为(2.07±0.85)d、(2.75±0.91)d,拔除尿管时间分别为(2.21±0.67)d、(3.45±1.22)d,术后首次下床活动时间分别为(4.55±1.17)d、(6.28±1.36)d,术后住院时间分别为(10.69±2.27)d、(12.86±3.61)d,观察组均短于对照组(P<0.05);手术后观察组与对照组血清白细胞介素-6(IL-6)水平分别为(63.09±7.25)ng/L、(69.71±8.43)ng/L,皮质醇(Cor)水平分别为(328.95±41.75)μg/L、(451.37±53.62)μg/L,C反应蛋白(CRP)水平分别为(22.64±7.78)mg/L、(34.51±11.92)mg/L,观察组均低于对照组(P<0.05);观察组与对照组术后并发症发生率分别为5.00%、20.00%,观察组低于对照组(P<0.05)。结论腹腔镜下低位直肠癌根治术与常规开腹手术治疗低位直肠癌在手术时间、淋巴结清扫数目、保肛率等方面效果接近,但腹腔镜下低位直肠癌根治术手术创伤较小,有利于减轻炎症反应、减少术后并发症,有助于术后早期康复。Objective To observe the short-term efficacy and safety of laparoscopic radical resection of low rectal cancer and conventional open radical resection of rectal cancer.Methods 80 patients with low rectal cancer admitted to a hospital from April 2021 to April 2023 were divided into the observation group and the control group by random number table method,40 cases in each group.The observation group underwent laparoscopic radical resection of low rectal cancer,the control group underwent conventional laparotomy radical resection of rectal cancer.The perioperative indexes,circumferential margin status,anal preservation rate,postoperative recovery,serum inflammatory factor level and postoperative complication rate were compared between the two groups.Results There was no significant difference in operation time and number of lymph nodes dissection between the two groups(P>0.05).The intraoperative blood loss of the observation group and the control group were(90.24±23.34)ml and(148.02±18.67)ml,and the incision length were(5.17±0.94)cm and(14.75±2.26)cm,respectively.The intraoperative blood loss and incision length of the observation group were less than those of the control group(P<0.05).There was no significant difference in the positive rate of periannular margin and anal preservation between the two groups after surgery(P>0.05).The first time of anal exhaust of the observation group and the control group were(2.07±0.85)d and(2.75±0.91)d,the time of catheter extraction were(2.21±0.67)d and(3.45±1.22)d,and the first time of getting out of bed were(4.55±1.17)d and(6.28±1.36)d,respectively.Postoperative hospitalization time of the observation group and the control group were(10.69±2.27)d and(12.86±3.61)d,and the observation group was shorter than the control group(P<0.05).The levels of interleukin-6(IL-6)and cortisol(Cor)in the observation group and the control group after operation were(63.09±7.25)ng/L and(69.71±8.43)ng/L,respectively,and(328.95±41.75)μg/L and(451.37±53.62)μg/L.C-reactive protein(CRP

关 键 词：腹腔镜 开腹 低位直肠癌 近期疗效 安全性 

分 类 号：R735.37[医药卫生—肿瘤]