改良三孔法与五孔法腹腔镜直肠癌手术的对比研究

目的:探索改良三孔法腹腔镜直肠癌手术的可行性与安全性。方法:回顾分析2012年2月至2012年7月收治的47例直肠癌患者,其中22例行改良三孔法腹腔镜直肠癌根治术(三孔组),25例行传统五孔法腹腔镜直肠癌根治术(五孔组)。对比分析两组患者手术时间、术中出血量、术后排气时间、拔出导尿管时间、住院时间、肿瘤直径、切除淋巴结检出数、下切缘长度、标本长度、吻合口漏、吻合口出血发生率等情况。结果:与五孔法腹腔镜组相比,三孔组手术时间稍长,术中出血量较多,但差异无统计学意义(P>0.05);两组患者术后排气时间、拔除导尿管时间、住院时间、切除淋巴结检出数、下切缘长度、标本长度、并发症发生率等差异亦无统计学意义(P>0.05)。结论:改良三孔法腹腔镜直肠癌根治术的有效性、安全性、根治性与五孔法腹腔镜手术差异无统计学意义,但三孔法可减少体表疤痕,有助于降低手术对患者造成的生理与心理创伤。

Comparative study of improved three-port and traditional five-port laparoscopic surgery for rectal cancer

Objective：To explore the feasibility and safety of laparoscopic rectal cancer surgery with improved three-port meth- od. Methods：During Feb. 2012 and Jul. 2012,47 cases of rectal cancer were treated. Among which 22 cases were performed improved three-port laparoseopic radical resection of rectal cancer and traditional five-port method was performed in the other 25 cases. Following data were retrospectively analyzed between the two groups such as operative time, bleeding volume, the time of exhaust, removal of the catheter, hospital stay, tumor diameter, number of lymph node harvested, length of inferior incised edge, length of the specimen, the inci- dence of anastomotic leakage and anastomotic bleeding. Results：Compared with traditional five-port laparoscopic group, three-port group had slightly longer operative time and more bleeding volume, but there was no statistically significant difference （ P 〉 0.05 ）. The other data also had no statistical difference （ P 〉 0.05 ）, such as the time of postoperative exhaust, removal of the catheter, hospital stay, num- ber of lymph node harvested, length of inferior incised edge, length of the specimen and the incidence of complications. Conclusions： The effectiveness, security, and radical resection of improved three-port laparoscopic operation has no statistical difference with tradition- al five-port laparoscopic rectal cancer surgery. However, three-port method can reduce the surface scar, help reduce physical and psy- chological trauma caused by surgery for patients.