[1]陆昌运﹡ 李裕永 卢挺斌 周俊成.腔镜与开腹手术治疗低位直肠癌的效果对比[J].中国微创外科杂志,2016,16(05):465-467.
　Lu Changyun,Li Yuyong,Lu Tingbin,et al.Comparison of Laparoscopic Versus Open Surgery for Low Rectal Cancer[J].Chinese Journal of Minimally Invasive Surgery,2016,16(05):465-467.
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腔镜与开腹手术治疗低位直肠癌的效果对比()

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
16
期数:
2016年05期
页码:
465-467
栏目:
经验交流
出版日期:
2016-08-17

文章信息/Info

Title:
Comparison of Laparoscopic Versus Open Surgery for Low Rectal Cancer
作者:
陆昌运﹡ 李裕永 卢挺斌 周俊成
（广西壮族自治区横县人民医院肛肠外科，南宁530300）
Author(s):
Lu Changyun;  Li Yuyong;  Lu Tingbin;  et al.
Department of Anorectal Surgery, People’s Hospital of Hengxian, Nanning 530300, China
关键词:
低位直肠癌; 腹腔镜; 治疗效果
Keywords:
Low rectal cancer; Laparoscopy; Curative effect
文献标志码:
B
摘要:
目的探讨腹腔镜与开腹手术治疗低位直肠癌的效果。方法回顾性分析我院2003年1月~2013年6月89例低位直肠癌患者的临床资料，45例行腹腔镜手术，44例行开腹手术，比较2组手术结果及并发症。结果与开腹组相比，腹腔镜组手术时间短［（160.5±25.4） min vs. （210.3±45.6）min，t=-6.387，P=0.000］，术中出血少［（120±21）ml vs. (320±53)ml, t=-27.650，P=0.000］，保肛率高［84.4%(38/45) vs. 59.1%(26/44), χ2=7.079，P=0.008］，术后肛门排气早［（3.2±1.2）d vs.(6.3±3.6)d, t=-5.477，P=0.000］，尿潴留少［4.4%(2/45) vs. 20.5%(9/44), χ2=5.264，P=0022］，总住院时间短［（10.3±2.4）d vs. (15.6±2.7)d, t=-9.793，P=0.000］,2组术后切口感染、肺部感染、肠梗阻、吻合口漏、标本切除长度及清扫淋巴结数量等方面差异无显著性（P>0.05）。67例获得随访1~5年，复发或肿瘤转移9例，其中6例死亡。结论对于低位直肠癌患者采取经腹腔镜的手术方式，能增加保肛率，而且具有手术创伤小、出血量少、尿潴留等并发症发生率低、术后肛门排气快、住院时间短等优点，疗效确切，值得临床推广。
Abstract:
ObjectiveTo explore the comparative efficacy between laparoscopic resection and open surgery for low rectal cancer.MethodsData of 89 patients who were diagnosed as having low rectal cancer from January 2003 to June 2013 in our hospital were enrolled, including 45 cases of laparoscopic resections and 44 cases of open surgeries. The curative effects of the two groups were evaluated. ResultsAs compared with the open group, the laparoscopic group had shorter operation time ［(160.5 ±25.4) min vs. (210.3±45.6) min, t=-6.387, P=0.000］, less blood loss ［(120±21) ml vs. (320±53) ml, t=-27.650, P=0.000］, higher anal preservation rate ［84.4% (38/45) vs. 59.1% (26/44), χ2=7.079, P=0.008］, earlier flatus time ［(3.2±1.2) d vs. (6.3±3.6) d, t=-5.477, P=0.000］, lower urinary retention rate ［4.4% (2/45) vs. 20.5% (9/44), χ2=5.264, P=0022］, and shorter total hospital stay ［(10.3±2.4) d vs. (15.6±2.7) d, t=-9.793, P=0.000］. There were no significant differences between the two groups in the postoperative incision infection, pulmonary infection, intestinal obstruction, anastomotic leakage, length of resected specimen and number of lymph node dissected (P>0.05). There were 67 cases followed up for 1-5 years, during which 9 cases of recurrence or tumor metastasis occurred, including 6 fatal cases. ConclusionsLaparoscopic approach is superior to open surgery regarding the rate of anal preservation in patients with low rectal cancer. The laparoscopic approach also has less surgical trauma, fewer bleeding and urinary retention, shorter hospital stay, and faster postoperative flatus time, being worthy of clinical application.

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备注/Memo

备注/Memo:
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更新日期/Last Update: 2016-08-17