完全腹腔镜直肠癌根治术(Dixon术式)治疗直肠癌的疗效研究

目的探讨完全腹腔镜直肠癌根治术(Dixon术式)治疗直肠癌的临床疗效。 方法回顾性分析2011年9月至2013年9月接诊的96例直肠癌患者，按照手术方法不同，分为开腹组、腹腔镜组，各48例。腹腔镜组进行完全腹腔镜Dixon术，开腹组进行开腹Dixon术。采用SPSS 18.0软件处理，两组围术期情况、肿瘤根治情况用均数±标准差表示，比较采用独立t检验；两组并发症、3年生存率采用χ²检验，P<0.05表示差异有统计学意义。 结果腹腔镜组手术时间长于开腹组，术中出血量、切口长度、肛门排气时间、下床活动时间、术后住院时间均比开腹组少/短，差异均具有统计学意义(P<0.05)；两组结肠切除长度、直肠切除长度、距下切缘距离以及结肠旁、系膜间、血管根部淋巴结清扫个数比较差异均无统计学意义(P>0.05)；腹腔镜组并发症总发生率为8.3%，明显少于开腹组的31.3%(χ²＝5.485, P<0.05)；腹腔镜组1～3年生存率分别为91.7%、77.1%、64.6%，与开腹组的89.6%、72.9%、62.5%比较差异均无统计学意义(P>0.05)。 结论在直肠癌患者中应用完全腹腔镜Dixon术式效果显著，具有创伤小、恢复快、并发症少的优点，且肿瘤根治情况、远期疗效开腹手术相似。

The effect of total laparoscopic radical resection of rectal cancer (Dixon) in the treatment of rectal cancer

ObjectiveTo study the effect of total laparoscopic radical resection of rectal cancer (Dixon) in the treatment of rectal cancer. Methods96 patients of rectal cancer treated in our hospital from September 2011 to September 2013 were retrospectively analyzed. According to different surgical methods, they were divided into laparotomy group and laparoscopic group, 48 cases in each group. The laparoscopic group was treated with total laparoscopic radical resection, Using SPSS18.0 software, the perioperative data and operative data of the two groups were expressed by mean±standard deviation ( ±s) and compared with the t test; the complications and 3 year survival rate of the two groups were counted by χ² test, P<0.05 indicated significant difference. ResultsThe operation time in the laparoscopic group was longer than that of the laparotomy group, and the intraoperative blood loss, incision length, anal exhaust time, ambulation time, and postoperative hospital stay were less/shorter than that of the laparotomy group, the differences were statistically significant (P<0.05); there was no significant difference in the length of removed colon, the length of removed rectum, the distance from the incisal margin and the number of lymph node dissection of pericolonic, membrane and vascular root between two groups (P>0.05); the total incidence of complications in laparoscopic group was 8.3%, which was significantly less than 31.3% in the laparotomy group (χ²=5.485, P<0.05); the 1~3 years survival rate of laparoscopic group was 91.7%, 77.1% and 64.6%, compared with laparotomy group 89.6%, 72.9%, 62.5%, the difference was not statistically significant (P>0.05). ConclusionTotal laparoscopic radical resection of rectal cancer is well for rectal cancer, it have the advantages of less trauma, faster recovery and less complications, the curative effect of tumor is similar to that of open surgery.