腹腔镜Miles术和开腹Miles术治疗低位直肠癌临床分析

目的:通过与传统的开腹Miles术治疗低位直肠癌比较,对比分析腹腔镜Miles术的安全性和可行性。方法:回顾性分析2005年1月～2008年6月我院低位直肠癌患者Miles术88例,其中腹腔镜组48例,遵循全肠系膜切除原则行腹腔镜低位直肠癌Miles术;开腹组40例,行常规开腹手术。对比两组患者手术时间、术中出血量、切除淋巴数、术后肠功能恢复情况、术后住院时间、并发症、住院费用等情况。结果:腹腔镜组术中出血量、肠功能恢复时间和住院天数均明显少于开腹组,且住院费用以及并发症发生率也均优于开腹组,但其手术时间较长,两组比较存在显著差异(P<0.05);此外,腹腔镜组切除淋巴结数与开腹组无显著差异(P>0.05)。结论:腹腔镜低位直肠癌根治术治疗直肠癌创伤小、康复快、安全可靠,短期随访效果肯定,值得推广。

Comparison of effect of Miles laparoscopic surgery and Miles laparotomy on low rectal cancer

Objective: To compare the clinical effects between Miles laparoscopic surgery and Miles laparotomy on low rectal cancer.Methods:A total of 88 cases of low rectal cancer admitted from January 2005 to June 2008 were selected,including 48 cases with Miles laparoscopic surgery and 40 cases with conventional Miles laparotomy.The operation time,hemorrhage volume during surgery,number of resected lymph,intestinal function after surgery,length of stay,complication,cost etc.were recorded and compared.Results:Patients in laparoscopic group showed significantly smaller hemorrhage volume,significantly shorter recovery time of intestinal function and length of stay,significantly lower cost and incidence of complication,but significantly longer surgery time(all P<0.05).There was no significant difference in number of resected lymph between two groups(P>0.05).Conclusions:Miles laparoscopic operation has small incision and quicker recovery.It is safe and reliable,and of confirmed short-term effect.It is worthy to be popularized.