直肠癌合并2型糖尿病患者腹腔镜与开腹手术近期疗效的比较

目的：探讨腹腔镜辅助下直肠癌前切除术与同期开腹手术对合并2型糖尿病患者短期疗效。方法：回顾性分析2年间解放军总医院实施直肠癌前切除术的97例患者的临床资料。其中43例行腹腔镜手术（腔镜组），54例行传统开腹手术（开腹组），比较两组术中及术后情况。结果：与开腹组比较，腔镜组术中失血量、切口长度、排气时间、开始进流食时间及术后住院天数均优于开腹组（均P<0.01），且总并发症发生率低于开腹手组（P=0.0479）。两组手术时间、淋巴结清扫个数及术后镇痛泵使用例数差异均无统计学意义（均P>0.05）。结论：腹腔镜直肠癌前切除术能有效减少直肠癌合并2型糖尿病患者术后并发症发生率，该术式对治疗直肠癌合并2型糖尿病是安全可行的，可作为首选术式。

Comparison of short-term efficacy of laparoscopic and open surgery for rectal cancer patients with concomitant type 2 diabetes

Objective: To compare the short-term efficacy of laparoscopic and open anterior resection for rectal cancer in patients with concomitant type 2 diabetes. Methods: The clinical data of 97 patients with concomitant type 2 diabetes undergoing anterior resection of rectal cancer at Chinese PLA General Hospital during past 2 years were retrospectively analyzed. Among the patients, 43 cases received laparoscopic surgery (laparoscopic group), and 54 cases were subjected to the traditional open surgery (open surgery group). The intra- and postoperative conditions between the two groups were compared. Results: Compared with open surgery group, the scenarios that included intraoperative blood loss, length of incision, time to flatus and food intake, and length of postoperative hospital stay were all significantly superior in laparoscopic group (all P<0.01). Moreover, the overall incidence of complications in laparoscopic group was lower than that in open surgery group (P=0.0479). There were no differences in operative time, number of dissected lymph nodes and number of patients requiring postoperative analgesia between the two groups (all P>0.05). Conclusion: Laparoscopic anterior resection can reduce the incidence of postoperative complications in rectal cancer patients complicated with type 2 diabetes, so it is safe and feasible, and can be considered as the first-choice procedure for those patients.