摘要
目的比较腹腔镜与开腹直肠癌根治术在直肠癌治疗中的应用效果。方法比较同一手术组的26例腹腔镜和54例开腹直肠癌根治术的保肛率、手术相关指标、术后恢复指标、肿瘤根治性指标、住院费用、术后并发症及随访结果。结果腹腔镜组的术后肛门排气时间、拔除导尿时间、术后住院天数分别为(4.2±1.8)d、(4.3±1.7)d及(10.4±2.4)d,开腹组分别为(5.5±1.4)d、(5.9±3.0)d及(14.3±3.4)d,腹腔镜组显著短于开腹组(P<0.05)。而腹腔镜组在保肛率(13/26)、手术时间[(198±20)m in]、术中出血量[(414±188)m l]、肿瘤大小[(3.2±0.7)cm]、切除标本长度[(16.5±2.4)cm)]、清扫淋巴结数目(9.0±3.1)及直肠肿瘤远端切缘长度[(3.2±1.3)cm]方面与开腹组比较差异无统计学意义(P>0.05)。腹腔镜组手术费用[(1.02±0.26)万元]高于开腹组[(0.61±0.19)万元](P<0.01),住院费用[(2.93±0.36)万元]高于开腹组[(2.39±0.29)万元](P<0.01)。腹腔镜组术后并发症明显少于开腹组(P=0.034)。两组局部复发及远处转移方面差异无统计学意义。结论腹腔镜直肠癌根治术安全、经济,且创伤小,恢复快,并发症少。
Objective To compare the effect of laparoscopic and open radical operation on rectal cancer. Methods Twenty - six laparoscopic and fifty - four open radical operation cases selected from the same surgical candidates were compared under the following parameters： anus preservation rate, surgical guidelines, postoperative recovery guidelines, tumor radical resection guidelines, hospitalization fee, overall morbidity rate, and postoperative outcome. Results In the laparoscopic group, bowel function restoration time, urinary catheter removal time, and duration of hospital stay after operation were （4. 2 ± 1.8） days, （4. 3 ± 1.7） days, and （ 10.4 ±2.4） days, respectively. The data for the open group were （5.5 ± 1.4） days, （5.9 ± 3. 0） days, and （14. 3 ±3.4） days, respectively. When compared to the open radical group, all the above values were significantly shorter in length in the laparoscopic group （ P 〈 0. 05 ）. No statistically significant difference was observed between the two groups in the anus preservation rate （ 13/26）, operation time[ （ 198 ±20）mini, mean operative blood loss[ （414 ± 188）ml], tumor size [ （3. 17 ± 0. 72） cm ], specimen length [ （ 16. 5 ± 2.4） cm ], number of lymph nodes excised （9. 0 ± 3.1 ）, and the distal margin [ （3.2 ± 1.3） cm ] （ P 〉 0. 05）. Laparoscopic operation fee [ （ 10. 2 ± 2.6） thousand RMB ] was more expensive than open surgical resection[ （6. 1 ± 1.9）thousand RMB] （ P 〈 0. 01 ）. Laparoscopic hospitalization fee [ （29.3 ± 3.6） thousand RMB ] was more costly than open surgical resection[ （23.9 ± 2.9）thousand RMB ] （ P 〈 0. 01 ）. The overall morbidity rate with laparoscopic operation was noticeably reduced in contrast to open surgical resection （ P = 0. 034）. There was no apparent difference in local recurrent and metastatic rates between the two groups. Conclusion Laparoscopic radical operation on rectal cancer is a technique that is safe, feasible, and less invasive compared to open surgical resection. Laparoscopic surgery also provides the benefit of early recovery and less morbidity.
出处
《临床医学》
CAS
2007年第2期11-13,共3页
Clinical Medicine
关键词
腹腔镜
直肠癌
根治术
Laparoscope
Rectal cancer
Radical operation
