腹腔镜直肠癌根治术65例

目的探讨腹腔镜直肠癌根治术的临床疗效。方法回顾分析2009年7月至2013年3月开展的65例腹腔镜直肠癌根治术和70例开腹直肠癌根治术临床资料，比较两组术中及术后相关指标。应用SPSS16．0软件进行统计学分析，计量资料采用中位数（最小值-最大值）[M（Min—Max）]表示，采用U检验；率的比较采用χ^2检验和Log．rank检验，检验水准0=0．05。结果腹腔镜组手术时间明显长于开腹组手术时间，腹腔镜组出血量明显少于开腹组，120．4（51～285．6）ml比400．5（260．3—890．3）ml，差异有统计学意义（U值=9．357，P=0．009）。两组淋巴结清扫数目差异无统计学意义（P〉0．05）。腹腔镜组术后排气时间、进食时间、尿管留置时间及住院时间均优于开腹组，差异有统计学意义（P=0．045、0．042、0．043、0．043）；术后并发症：腹腔镜组切口感染、脂肪液化明显少于开腹组（P=0．047）；两组吻合口漏发生率差异元统计学意义（P〉0．05）；腹腔镜组术后切口感染、切口疝等并发症少于开腹组（P〈0．05）。结论腹腔镜直肠癌根治术较开腹手术时间较长，但其疗效可靠，手术安全可行，具有微创优势，术中出血少，术后恢复快，住院时间短，并发症少，是治疗结直肠癌重要的手术方法，具有广阔的发展前景。

Laparoscopic resection of rectal cancer in 65 cases

Objective To explore the clinical efficacy of radical laparoscopic resection of colorectal cancer. Methods Sixty-five patients who underwent radical resection of laparoscopic colorectal cancer in our hospital from July 2009 to March 2013, and 70 patients with open radical resection of colorectal cancer were analyzed by intraoperative and postoperative indicators. SPSS16.0 software was used for statistical analysis, data were expressed with median （minimum and maximum ） [ M （Min-Max）]. The rate was detected using the chi-square test and Log-rank test, inspection level a = 0.05. Results The operation time in the laparotomy group was significantly longer than that in the open radical resection group, with blood loss 120.4 ml （51 - 285.6） less than 400. 5 ml （ 260.3 - 890. 3 ） in the two groups. The difference was statistically significant （ U = 9. 357, P = 0. 009）. The number of lymph node dissection was similar between the two groups （ P 〉 0.05 ）. The laparoscopic group was superior to the open radical resection group in postoperative exhaust time, eating time, urine tube indwelling time and hospital stay （P = 0. 045, 0. 042, 0. 043, 0. 043）. Postoperative complications including fat liquefaction of incision infection were less in the laparoscopic group than in the open radical resection group （ P = 0. 047 ）. The incidence of anastomotic leakage was similar between the two groups （ P 〉 O. 05 ）. Conclusions Although laparoscopic radical resection of colorectal cancer needs a longer operating time than open radical resection, its curative effect is reliable, it has advantages of minimally invasive, less intraoperative bleeding, quick recovery, short hospitalization time, and few complications. Laparoscopic radical resection of colorectal cancer is feasible for the treatment of colorectal cancer.