结、直肠癌腹腔镜手术与开放手术的临床对比分析

目的比较结、直肠癌腹腔镜手术与开放手术的优缺点，探讨腹腔镜在结、直肠癌手术中的应用价值。方法结、直肠癌患者234例，其中腹腔镜手术组103例，开放手术组131例，两组进行对比分析。结果腹腔镜手术组平均手术时间长，术中失血量少，术后排气时间、进食时间、下地活动时间早，住院时间短（均P〈0．05）。两组切除肿瘤直径、切除肠系膜淋巴结数、Dixon术肿瘤距下切端长度差异均无统计学意义（P〉0．05）。腹腔镜手术组患者肠系膜的完整性比开放手术组好（P〈0．001）。结论经腹腔镜行结、直肠癌手术安全可行，术中出血少，胃肠功能恢复快、住院时间短，近期效果满意。

Clinical comparison and analysis of laparoscopic and open operation for colorectal neoplasms

Objective To evaluate the feasibility and short-term outcome of laparoscopic operation for colorectal neoplasm in comparison with open operation procedure for colorectal neoplasm, laparoscopic operation for colorectal neoplasm may be critical in the evolving practice of medieine. Methods 234 cases of colorectal neoplasm were divided into two groups and was analyzed. 103 patients with colorectal neoplasm underwent laparoscopic operation (LCS), while 131 cases received open operation (OCS). Results The mean operating time in laparoscopic operation group was significantly longer than in open operation group (P <0.05). The blood loss was less. Time to pass flatus, time to ambulate and return of bowel function were restored earlier in laparoscopic operation group than that in open operation group (P <0.05). Duration of hospital stay were longer in open operation group than that in laparoscopic operation group (P <0.05). There was not significant difference in the length, distal margin, size of tumors and number of removed lymphatic nodes(P > 0.05) between the two groups. Laparoscopic colorectal resection is better in pathologic sample compared with the traditional open operation procedure. Conclusion Laparoscopic colorectal resection is secure and effective for colorectal neoplasm, and it is with lower blood loss during operation,earlier return of bowel function and shorter hospitalization, and provide better short-term outcome compared with the traditional open procedure.