腹部无辅助切口腹腔镜直肠癌根治术的效果分析

目的探讨腹部无辅助切口完全腹腔镜下经肛门直肠外翻拖出式直肠癌根治术的手术方法及效果。方法回顾性分析2013年1月至2014年6月采用腹腔镜手术治疗的低位/超低位直肠癌患者87例,其中22例患者采用最新的腹部无辅助切口完全腹腔镜下经肛门直肠外翻拖出式直肠癌根治术治疗(无辅助切口组)、采用传统腹腔镜手术方法治疗65例(传统组),对比两组的手术效果。数据分析采用SAS 10.0软件处理,围手术期指标采用均数±标准差(x珋±s)表示,组间比较采用t检验;总生存率、复发率、并发症率比较采用χ2检验;P值0.05表示差异具有统计学意义。结果无辅助切口组患者的手术出血量、胃肠道功能恢复时间、住院时间、住院费用均显著的低于传统组患者,差异具有统计学意义(P0.05);两组患者的清扫淋巴结数目、手术时间、术后并发症率、排便习惯改变率、2年生存率、2年复发率比较差异均无统计学意义(P0.05)。结论腹部无辅助切口完全腹腔镜下经肛门直肠外翻拖出式直肠癌根治术与传统腹腔镜手术的效果无差异,但是具有手术创伤更小、术后恢复更快的优势。

Clinical analysis of laparoscopic radical resection of rectal cancer without auxiliary incision

Objective To investigate the efficacy and feasibility of total laparoscopic radical resection of rectal cancer by dragging specimen out transanal without abdominal incision . Methods Retrospective analysis were performed in 87 patients with low/super low rectal cancer , who underwent laparoscopic surgery from January 2013 to June 2014, while 22 cases were treated without auxiliary incision in Auxiliary incision group and 65 cases were treated with traditional in Traditional group Clinical data were analyzed by using SAS 10.0 software, perioperative indicators were expressed as mean ±standard deviation ( x-±s), and were examined by using t test.Count data, such as total survival rate , recurrence rate and complications were expressed as%, and were examined by using x2 test.A P value <0.05 was considered as statistically significant difference . Results The amount of bleeding , recovery time of gastrointestinal function , length of stay and hospital costs were significantly lower in the Auxiliary incision group than those in the traditional group, with significant difference (P<0.05).There were no significant differences in terms of harvested lymph nodes, operation time, postoperative complication rate , bowel habit, 2 year survival rate and 2 year recurrence rate between the two groups ( P >0.05 ). Conclusion Compared with conventional laparoscopic surgery, there were no significant difference in terms of clinical outcome by total laparoscopic radical resection of rectal cancer by dragging specimen out transanal without abdominal incision , however with advantages of less trauma and quicker recovery .