手助腹腔镜与传统开腹直肠癌根治术的临床对比

目的探讨手助腹腔镜直肠癌根治术的应用价值。方法回顾性分析我院2009～2011年直肠癌经手助腹腔镜（28例）和开腹（32例）行直肠前切除手术的临床资料,对比2组手术时间、术中出血量、肠系膜淋巴结清扫个数、肠道功能恢复时间、术后住院时间、术后并发症的发生率之间的差异。结果手助腹腔镜组在术中出血量、肠道功能恢复时间及术后住院时间均少于开腹组[术中出血量（80.5±13.3）ml vs.（170.5±35.5）ml,t=-12.650,P=0.000;肠道功能恢复时间（45.4±15.8）h vs.（89.5±13.3）h,t=-11.750,P=0.000;术后住院时间（8.2±2.0）d vs.（11.6±2.0）d,t=-6.518,P=0.000]。2组手术时间、淋巴结清扫数目、术后并发症发生率差异无显著性（P〉0.05）。结论手助腹腔镜与开腹直肠癌根治术相比具有出血少、术后恢复快等优点,具有微创性,同时并不增加手术时间及术后并发症,能获得和开腹同样的根治效果。

Comparison between Hand-assisted Laparoscopy and Traditional Open Surgery for Radical Resection of Rectal Cancer

Objective To compare the efficacy of hand-assisted laparoscopic surgery and traditional open surgery for radical resection of rectal cancer.Methods A retrospective analysis was made on the clinical data of 60 patients,who received anterior resection of the rectum in our hospital from 2009 to 2011.Among the patients,hand-assisted laparoscopic surgery was made on 28 cases,and open surgery was carried out in the other 32 patients.The operation time,intraoperative blood loss,number of removed mesenteric lymph nodes,and rate of postoperative complications were compared between the two groups.Results The laparoscopic group showed significantly less intraoperative blood loss,shorter recovery time of intestinal function,and shorter postoperative hospital stay than the open group[(80.5±13.3)ml vs.(170.5±35.5)ml,t=-12.650,P=0.000;(45.4±15.8) h vs.(89.5±13.3)h,t=-11.750,P=0.000;and(8.2±2.0) d vs.(11.6±2.0)d,t=-6.518,P=0.000].No significant difference was found in the operation time,number of removed mesenteric lymph nodes,and rate of postoperative complications(all P>0.05) between the two groups.Conclusions Hand-assisted laparoscopy is as effective as traditional open surgery for radical resection of rectal cancer,but is less invasive resulting in less intraoperative blood loss and quicker recovery of intestinal function.Litter difference was observed in operation time and rate of postoperative complications between the two procedures.