摘要
目的对比腹腔镜与开腹手术治疗直肠癌的临床疗效,探讨腹腔镜治疗直肠癌的可行性、安全性及短期疗效。方法回顾性分析2010-2013年间340例c T3N0-2中低位直肠癌患者,按1∶1随机接受开腹手术(n=170)或腹腔镜手术(n=170)。比较2组患者的临床基本状况、围手术期并发症、手术恢复情况等指标,环周切缘、全直肠系膜标本的宏观质量、清扫的淋巴结数量、肠功能恢复、围手术期并发症、术后疼痛、生活质量等因素参与了短期结果评估。结果失血量腹腔镜组平均200 ml,开腹组平均217 ml,P=0.006;手术时间腹腔镜组平均244.9 min,开腹组197.0 min;肠道功能恢复时间腹腔镜组38.5 h,开腹组60 h;恢复正常饮食时间腹腔镜组85 h,开腹组93 h;首次排便时间,腹腔镜组96.5 h,开腹组123 h;吗啡用量腹腔镜组平均107.2 mg,开腹组平均156.9 mg;身体评分腹腔镜组0.501(122例),开腹组-4.970(128例)。2组围术期并发症发生率无统计学意义。结论腹腔镜手术治疗直肠癌是安全有效的。
Objective To compare the clinical efficacy of laparoscopic surgery and open surgery for rectal cancer,and to explore the feasibility,safety and short-term curative effects of laparoscopic surgery for rectal cancer. Methods 340 patients with c T3N0-2 mid or low rectal cancer were randomly divided into 2 groups,respectively received open surgery( n = 170) and laparoscopic surgery( n = 170),Clinical basic status,perioperative complications,and recovery were compared. Short-term outcomes assessed circumferential resection margin,macroscopic quality of the total mesorectal excision specimen,number of harvested lymph nodes,recovery of bowel function,perioperative morbidity,postoperative pain,and quality of life. Results Blood loss in the laparoscopic group and the open group were 200. 0 ml and 217. 5 ml( P = 0. 006),surgery time in the laparoscopic group and the open group were 244. 9 min and 197. 0 min( P < 0. 0001),recovery of bowel function in the laparoscopic group and the open group were 38. 5 h and 60. 0 h( P < 0. 0001); time to resume normal diet in the laparoscopic group and the open group were 85. 0 h and93. 0 h( P < 0. 0001); time to first defecation in the laparoscopic group and the open group were 96. 5 h and 123 h( P < 0. 0001).The total amount of morphine used in the laparoscopic group and the open group were 107. 2 mg and 156. 9 mg( P < 0. 0001),physical functioning score in the laparoscopic group and the open group were 0. 501( n = 122) and- 4. 970( n = 128)( P =0. 0073). There had no significant difference in perioperative complications between the 2 groups. Conclusion Laparoscopic operation is safe and effective for rectal cancer.
出处
《实用癌症杂志》
2015年第3期420-422,共3页
The Practical Journal of Cancer
关键词
腹腔镜手术
开腹手术
直肠癌
安全性
短期疗效
Laparoscopic surgery
Open surgery
Rectal cancer
Safety
Short-term curative effect
