应用小切口方法根治直肠癌

目的:比较小切口方法和传统的直切口方法行直肠癌根治术的预后.方法:从2001年4月至2002年12月对78例直肠癌患者用小切口方法行直肠癌根治术.切口从髂前上嵴与耻骨联合的连线上方2 cm处作一7～10 cm的切口.同一时期有86例按传统的直切口方法行直肠癌根治术,并将其作为对照组.结果:78例患者通过小切口全部成功地行直肠癌根治术;两组患者的一般情况、手术类型、肿瘤的组织类型无显著差别(P>0.05),然而,小切口组的切口长度明显比传统组短(9.38 vs 17.32),小切口组的手术时间、所需止痛药时间、术后第一次排气时间和开始进流质时间,以及术后住院时间均显著性比对照组要短(P<0.05).平均随访25.4个月,未发现肿瘤复发.结论:小切口方法可作为直肠癌根治术的较好选择.

Minilaparotomy approach for curative resection of colorectal cancer

Objective: To evaluate the feasibility and safety of a minilaparotomy approach for curative resection of colorectal cancer in comparison with the conventional laparotomy. Methods: Seventy-eight patients underwent radical resection for rectal cancer with minilaparotomy during Aprial 2001 to December 2002. The minilaparotomy involved complete resection and a skin incision 2 cm above the link line of left anterior superior iliac spine to pubic symphysis and was about 7-10 cm in length. Another 86 patients who served as control group underwent a similar resection with a conventional laparotomy during the same period. Results: The minilaparotomy approach was successful in all 78 patients. The general status of patients,operative types and histopathological features of tumor were similar in the two groups (P>0.05). Operative blood loss in control group was greater (P<0.001),whereas incision length in minilaparotomy group was significantly shorter than that in conventional laparotomy (9.38 cm vs 17.32 cm). The operative time,analgesia requirement,first passing flatus,first oral fluids and postoperative hospital stay were significantly shorter in the minilaparotomy group (P<0.001). In an average 25.4-month follow-up,there were no tumor recurrences in the minilaparotomy group. Conclusion: A minilaparotomy approach for curative resection of rectal cancer may be an ideal alternative approach to conventional laparotomy.