手助腹腔镜与全腹腔镜外科治疗结直肠癌的对比研究

目的比较手助腹腔镜与全腹腔镜在外科治疗结直肠癌中的近期疗效，另外对手辅助腹腔镜外科治疗结直肠癌的安全性做出评估。 方法选取2011年11月至2014年4月哈尔滨医科大学附属第二医院结直肠肿瘤外科的79例结直肠癌患者，其中接受腹腔镜下结直肠癌根治术者41例，接受手辅助腹腔镜下结直肠癌根治术者38例。根据2种术式分为全腹腔镜组（LAC组）和手助腹腔镜组（HALS组）。通过回顾性分析，比较2组患者的一般资料包括年龄、性别、肿瘤位置、肿瘤病理类型、分期、ASA分级、BMI指数等；手术资料包括手术时间、麻醉时间、术中出血量、中转开腹率、取标本切口长度、Trocar数目等；术后资料包括术后第一次排气时间、术后住院时间、住院费用、术后并发症情况等。 结果HALS组和LAC组两组手术时间、麻醉时间、术中出血量、Trocar使用数目、取标本切口长度、术后首次排气时间存在差异（P<0.05）；术后住院时间、住院费用、术后并发症差异无统计学意义（P>0.05）。 结论手辅助腹腔镜下结直肠癌根治术与全腹腔镜下结直肠癌根治术相比具有手术时间短、创伤小、术后恢复快等优点，是一种安全有效，可靠的技术。

A comparative surgical study of hand-assisted laparoscopic and laparoscopic in recently clinical therapeutic of colorectal neoplasms

ObjectiveTo compare the recently clinical therapeutic effect of hand-assisted laparoscopic and pure laparoscopic surgery for colorectal tumors. In addition we evaluated the safety of hand-assisted laparoscopic in curing the colorectal tumors. MethodsRetrospectively chose 79 patients with colorectal tumors from November 2011 to April 2014 in Second Affiliated Hospital of Harbin Medical University.The number of patients who received the abdominal laparoscopic colectomy is 41,the number of hand-assisted laparoscopic colectomy is 38. According two kinds of surgical procedures into abdominal laparoscopic group (LAC group) and hand-assisted laparoscopic group (HALS group). By retrospectively analysis, compared the general information of two groups of patients including age, sex, tumor location, tumor histological type, stage, ASA grade, BMI index; surgery information, including operative time, anesthesia time, blood lossing, laparotomy rate specimens incision length, trocar numbers, etc; postoperative data including exhaust time, postoperative hospital stay, cost of hospitalization, postoperative complications, etc. ResultsThere has a difference between HALS group and LAC group in operative time, anesthesia time, blood lossing, Trocar used numbers, specimens incision length (P<0.05). But the difference of postoperative hospital stay, cost of hospitalization , postoperative complications have no significant (P>0.05). ConclusionsThe result of comparing the two types of surgical procedures in colorectal tumors, hand-assisted laparoscopic and pure Abdominal laparoscopic, HALS have many advantages like the shorter operative time, less invasive, quick recovery, hand-assisted laparoscopic is a a safe, effective and reliable technology.