腹腔镜与开腹手术治疗结直肠癌的临床疗效观察

目的对比腹腔镜与开腹手术治疗结直肠癌的临床疗效与安全性。方法对眉山市人民医院2010年1月-2012年12月进行腹腔镜与传统开腹结直肠癌根治术病例共87例进行统计学分析,其中腹腔镜结直肠癌根治术（腹腔镜组）42例,常规开腹结直肠癌根治术（开腹组）45例,对上述两组病例对照研究围术期临床指标及随访情况。结果两组患者手术时间、切除肠管长度、清扫淋巴结数量方面差异无统计学意义（P〉0.05）,但腹腔镜组术中失血量明显少于开腹组,并且术后镇痛时间、术后肠道功能恢复时间及术后平均住院时间均短于开腹组（P〈0.05）,生存质量均优于开腹组（P〈0.05）。腹腔镜术后并发症发生率为7.14%（3/42）,开腹组术后并发症发生率为20.00%（9/45）（P〈0.05）;随访6-12月,两组患者局部复发率（2.38%vs 6.67%）和远处转移率（2.38%vs4.45%）差异无统计学意义（P〈0.05）。结论应用腹腔镜行结直肠癌根治术具有微创、安全、恢复快、住院时间短、术后生存质量优于开腹组;而在手术彻底性、局部复发率与远期生存率方面与传统开腹手术无明显差异。

Clinical comparative study of laparoscople operation and traditional open surgery rectal cancer

Objective To investigate the clinical efficacy and safety of laparoscople operation and traditionl surgery for rectal cancer.Methods Laparoscople operation and open surgery were performed for 80 patients with rectal cancer from January 2010 to December 2012 in People＇s Hospital of Meishan City,the clinical data of which were collected and analyzed retrospectively,including laparocopic radical resection of colorectal carcinoma（laparoscopic group） in 42 cases and traditional open radical resetion of colorectal carcinoma（open surgery group） in 45 cases,the two groups cases control studied the peri operation period of clinical indicators and follow-up.Results Two groups of patients with resection operation time,resection of intestinal segment length,and dissection of the lymph node number was no statistical significance（P 0.05）,but the volume of intraoperative blood loss of the laparoscopic group was significantly less than open group,And the furation of postoperative analgesia,potoperative intetinal function recovery time and the mean postoperative hospital stay were shorter than the open group（P 0.05）,the quality of life were better than open surgery group（P 0.05）,laparoscople postoperative complication rate was 7.14%（3/42）,the postoperative complication rate of open group was 20.00%（9/45）（P 0.05）;after follow-up two group patients in 6-12 months,there was no statistical difference in local recurrence rate（2.38% vs 6.67%） and distant metastasis rate（2.38% vs 4.45%）（P 0.05）.Conclusion The application of laparoscopic radical reection of colorecatal carcinoma otoperative quality of life with invasive line,safety,quick recovery,shorter hospitalization time,and better than open group,radical opration,local recurrence rate and long term survival rate has no significant difference among two groups.