腹腔镜与开腹结直肠癌完整系膜切除术的短期随访研究

目的：比较腹腔镜与开腹完整系膜切除术治疗结直肠癌的临床疗效。方法选择2012年3月—2015年2月收治的结直肠癌患者74例。按照手术方式分为腹腔镜组40例与开腹组34例，回顾性分析两组临床资料，比较两组手术疗效、术后恢复及短期随访结果。结果腹腔镜组保肛率高于开腹组( P<0．05)；腹腔镜组切口长度短于开腹组(P<0．05)，术中出血量少于开腹组(P<0．05)，其手术时间略长于开腹组(P<0．05)。腹腔镜组术后恢复情况优于开腹组(P<0．05)。腹腔镜组并发症总发生率低于开腹组(P<0．05)。两组肿瘤根治性指标及术后6个月肿瘤复发、转移率对比差异无统计学意义(P>0．05)。结论采用腹腔镜完整系膜切除术治疗结直肠癌短期疗效与开腹手术相近，且患者术后恢复速度更快，并发症发生率更低，安全性更高。

A Short-term Follow-up Study on Open and Totally Laparoscopic Mesorectal Excision in Treatment of Patients with Colorectal Cancer

Objective To compare clinical effects between open and totally laparoscopic mesorectal excision in treatment of patients with colorectal cancer. Methods A total of 74 patients with colorectal cancer admitted between March 2012 and February 2015 were divided into laparoscopic group (n=40) and open group (n=34) according to sur-gical methods. Clinical data of patients in two groups was retrospectively analyzed, and surgical effects, postoperative re-covery and short-term follow-up outcome were compared in two groups. Results Compared with those in open group, in laparoscopic group, anus preserving rate was higher (P<0. 05);incision length was shorter (P<0. 05), and intraoper-ative bleeding volume was less (P<0. 05); operative time was slightly longer (P<0. 05); conditions of postoperative recovery were better (P<0. 05);total incidence rate of complications was lower (P<0. 05). The differences in radical cure indexes for cancer, and recurrence and metastasis rates of tumor in postoperative 6 months were not statistically sig-nificant (P>0. 05). Conclusion Totally laparoscopic mesorectal excision in treatment of patients with colorectal cancer has similar short-term curative effect with better postoperative recovery, lower incidence rate of complications and safer compared with those by open surgery.