手辅助腹腔镜与传统开腹直肠癌根治术的对比研究

目的通过手辅助腹腔镜与开腹下直肠癌根治术的对比研究，评估手辅助腹腔镜在直肠癌根治手术中应用的优劣。 方法对本院103例接受手辅助腹腔镜和开腹手术的直肠癌患者的基本临床资料、手术切口、术中出血、手术时间、术后恢复、病理结果、近期疗效等进行统计学分析。 结果两组患者的基本临床资料无统计学差异，手辅助腹腔镜组的手术切口长度、手术出血量、术后住院天数、术后镇痛、术后排气时间等方面明显优于开腹组，两组在手术时间、术后并发症发生率等方面无统计学差异。术后两组患者平均随访26个月，各自出现2例远处转移及复发，无切口种植情况。 结论手辅助腹腔镜直肠癌根治术是安全的微创手术方式，具有住院时间短、进食及肠道功能恢复快，疼痛减轻，出血量较少，手术彻底性良好的特点。

Comparison of hand-assisted laparoscopic surgery andlaparotomy approach in curative resection of rectal carcinoma

ObjectiveThis prospective, randomized study compared the outcomes of hand-assisted laparoscopic surgery(HALS)with laparotomy approach resection of rectal carcionma. Methods103 cases of rectal cancer patients received HALS and laparotomy approach surgery.The main outcome measures were the distance of tumor to anus, procedure time, blood loss, length of abdominal incision, post-operative abdominal drainage, return function, length of hospital stay, morbidity and pathology results. ResultsGeneral status and the histopathological features of tumours were similar in two groups.Length of abdominal incision, surgical blood loss, post-operative hospital stay length, mean duration of narcotic analgesia, time to first passing flatus, and postoperative venous high nutrition application were better in HALS than open approach surgery.Procedure times and post-operative morbidity were similar in two groups.At a median follow-up of 26 months, two recurrence cases occurred in each group. ConclusionIn this study, the HALS for curative resection of rectal carcinoma was safe and effective and may offer several potential advantages to patients in their post-operative recovery.