腹腔镜与开腹低位直肠癌保肛根治术的临床对照研究

目的:探讨低位直肠癌行腹腔镜保肛根治术的可行性及近期临床疗效。方法:回顾分析2010年6月至2013年6月为26例患者行腹腔镜低位直肠癌保肛根治术的临床资料,并与同期行开腹保肛手术的41例低位直肠癌患者进行对比。结果:67例患者均顺利完成手术。腹腔镜组术中出血量、切口长度、肛门排气时间及住院时间优于开腹组,差异有统计学意义(P<0.05)。手术时间、淋巴结清除数量两组相比差异均无统计学意义(P>0.05)。两组并发症发生率分别为23.1%与63.4%,差异有统计学意义(P<0.05)。术后随访3~36个月,两组随访结果差异无统计学意义(P>0.05)。结论:腹腔镜低位直肠癌保肛根治术是微创、可行、安全的,在操作上较开腹手术暴露良好、解剖精细,可进一步提高保肛率,术后患者痛苦少、康复快,可同时达到根治要求。

Clinical control study of laparoscopic and open anal-preserving radical resection for low rectal cancer

Objective：To evaluate the feasibility and short-term therapeutic efficiency of laparoscopic anal-preserving radical resection for low rectal cancer. Methods：From Jun. 2010 to Jun. 2013,26 patients with low rectal cancer received laparoscopic radical resection ,while 41 patients underwent conventional open radical resection. The data of operative procedures, postoperative recovery, postoperative complication and short-term outcome were collected and compared between the two groups. Results ： The two groups of op- erations were all successful. The differences of the blood loss, length of incision, postoperative bowel function recovery time and hospital stay were statistically significant （ P 〈 0.05 ） , the effects of laparoscopic surgery group were better than those of conventional open oper- ation. The mean operation time and the mean number of dissected lymph nodes were not statistically different between two groups （ P 〉 0.05 ）. The incidence of postoperative complications was 23.1% in laparoscopic group, which was significantly lower than that in lapa- rotomy group （ 63.4% ）. 67 patients were followed-up from 3 to 36 months, there were no significant differences between two groups. Conclusions ： Laparoscopic anal-preserving radical surgery is a minimally invasive, safe and feasible procedure for low rectal cancer with some advantages such as clearer exposure, better anatomy, higher rate of anal preservation, less postoperative pain, and quicker recover-y, meanwhile it can achieve the requirements for radical treatment.