微创技术在老年直肠癌根治术中的临床应用研究

目的：探讨微创镜技术在老年直肠癌根治术中的临床应用价值。方法：将240例老年直肠癌患者随机分为腹腔镜组和开腹组，各120例。开腹组患者行传统开腹直肠癌全系膜切除术，腹腔镜组行腹腔镜下直肠癌根治术。比较两组患者的围手术期情况、术后近期并发症发生情况和术后随访情况。结果：腹腔镜组的手术时间、术中失血量、术后镇痛率、排气时间和住院时间均明显低于开腹组，差异均有统计学意义（P〈0.01或0.05）；腹腔镜组和开腹组术后并发症发生率分别为15.0%和49.2%，差异有统计学意义（P〈0.001）；两组患者局部复发率、远处转移率和5年总生存率比较差异均无统计学意义（P〉0.05）。结论：相对开腹手术而言，腹腔镜直肠癌根治术具有更好的短期疗效，且两者远期疗效相当，有望成为老年直肠癌患者常规外科治疗方法，值得临床推广应用。

Clinical Application of Minimally Invasive Technique in Radical Operation of Rectal Cancer in the Elderly

Objective：To investigate the clinical value of minimally invasive technique in radical operation of rectal cancer in the elderly.Method：A total of 240 cases of the elderly rectal cancer were randomly divided into the laparoscopic and laparotomic groups,each of 120 cases. The latter underwent open total mesorectal excision of rectal cancer while the former did laparoscopic radical resection of rectal cancer.The perioperative situation,postoperative short-term complications and follow-up of two groups were compared. Result：The operation time,perioperative blood loss, postoperative analgesia,exhaust time and hospital length in the laparoscopic groups were lower significantly than those in the open group（〈0.01 or P〈0.05）.The incidences of postoperative complications were 15%and 49.2%respectively （P〈0.001）.There were no significant differeces in local recurrence rate,distant metastasis rate and total survival rate of 5 years（P〉0.05）.Conclusion：Compared with the laparotomy,the laparoscopic radical resection of rectal cancer posseses the better short-term efficacy,with the same the long-term efficacy,prosmosing the routine surgical method for the elderly rectal caner patients and deserving the clinical use extensively.