腹腔镜超低位直肠癌根治术疗效的临床对照研究

目的 比较腹腔镜及开腹超低位直肠癌根治术的疗效.方法 选取超低位直肠癌患者76例为研究对象,根据随机数字表法将患者随机分为观察组和对照组,每组各38例.观察组采用腹腔镜超低位直肠癌根治术,对照组采用开腹超低位直肠癌根治术.比较两组患者的手术指标、术后恢复指标及术后随访情况.结果观察组患者的手术时间长于对照组,术中出血量少于对照组,系膜完整比例高于对照组,差异均有统计学意义(P<0.05);两组患者的淋巴结清除数量、远切端距离及并发症发生情况比较,差异均无统计学意义(P>0.05);观察组患者的排气时间、进食流质时间及导尿管留置时间均短于对照组,镇痛需要率低于对照组,差异均有统计学意义(P<0.05);两组患者的随访时间分别为(30.3±4.3)个月和(31.4±3.5)个月;两组患者的肛门功能、术后复发及远处转移情况比较,差异均无统计学意义(P>0.05).结论 腹腔镜超低位直肠癌根治术疗效可靠,且手术损伤小,术后恢复快,值得在临床治疗中推广应用.

Clinical comparative study of the effect of laparoscopic radical resection for ultra-low rectal cancer

Objective To compare the curative effect of laparoscopic and open radical surgery for ultra-low rectal cancer. Method 76 patients with ultra-low rectal cancer were included in the study, and were stratified as study group or control group as per a random number table, with 38 cases in each. The study group was treated by laparoscopic radical resection for ultra-low rectal cancer, while the control group was administered with open surgery, and the surgery mea-sures, postoperative recovery and follow-up of the two groups were compared. Result The operative time was longer in study group than that of the control group, and less intra-operative blood loss was observed in study group, besides, the proportion of patients with intact mesentery was higher in study group than in control group, and all were of statistically significant differences (P<0.05);There was no significant difference between the two groups in respect of the number of resected lymph nodes, the distance to the distal margin and the incidence of complications (P>0.05);The study group had shorter time to first flatus, time to liquid diet and time of indwelling urinary catheter, and decreased need for analgesics than the control group (P<0.05);The follow-up time were (30.3 ± 4.3) months and (31.4 ± 3.5) months in study group and control group, respectively, while the anal sphincter function and postoperative recurrence and distant metastasis were similar between the two groups (P>0.05). Conclusion The laparoscopic radical resection for ultra-low rectal cancer is re-liable and effective, causing minor surgical injury, with fast recovery, and it is clinically applicable.