腹腔鏡與開腹手術在直腸癌臨床中的療效比較

[摘要] 目的 探討腹腔鏡與開腹手術在直腸癌臨床中的療效。方法 整群選擇2014年6月—2015年6月期間該院進行直腸癌手術治療的患者76例，隨機分為觀察組和對照組各38例，觀察組給予腹腔鏡手術，開腹組基于傳統開腹手術，觀察兩組患者手術相關指標、術后并發癥以及術后1年復發與轉移情況。結果 觀察組患者手術時間長于對照組，術中出血量、術后首次排氣時間、首次排便時間、開始進流食時間、下床活動時間、切口長度以及術后住院時間均短于對照組，差異有統計學意義（P<0.05）；兩組患者并發癥發生率單項比較差異無統計學意義（P>0.05），但總體發生率觀察組為18.42%，明顯少于對照組44.74%，差異有統計學意義（P<0.05）；兩組患者隨訪1年，局部復發率分別為5.26%、7.89%，遠處轉移率分別為2.63%，10.53%，差異無統計學意義（P>0.05）。結論 腹腔鏡手術創傷小，患者恢復快，療效穩定，并發癥發生率更低，行直腸癌根治術安全可行。

[關鍵詞] 腹腔鏡；開腹手術；直腸癌

[中圖分類號] R61 [文獻標識碼] A [文章編號] 1674-0742（2016）12（c）-0069-03

[Abstract] Objective To observe the clinical effect of laparoscopic and open surgery in the treatment of rectal cancer. Methods Group selection of 76 patients with rectal cancer in our hospital from June 2014 to June 2015， randomly divided into observation group and control group， each of 38 cases， the observation group were given laparoscopic surgery， open group based on traditional open surgery， 1 groups of patients were observed in two groups of patients with surgery related indicators， postoperative complications and recurrence and metastasis. Results The operation time of the observation group was longer than that of the control group， And the amount of bleeding during operation， after the first exhaust time， first defecation time， began to flow into the food time， ambulation time， incision length， postoperative hospitalization time was shorter than the control group the difference was statistically signoficant（P<0.05）； There was no statistical difference in the incidence of complications between the two groups（P>0.05）， but the overall incidence rate was 18.42%， which was significantly less than that in the control group（44.74%）， and the incidence was statistically significant（P<0.05）； Two groups of patients were followed up for 1 years， the local recurrence rate was 5.26%， 7.89%， respectively， the distant metastasis rate was 2.63%， 10.53%， the difference was no statistically significant（P>0.05）. Conclusion Laparoscopic surgery is minimally invasive， rapid recovery， stable effect， lower incidence of complications， and safe operation of radical resection of rectal cancer.

[Key words] Laparoscope；Laparotomy； Rectal cancer

直腸癌是臨床常見的消化道腫瘤，其發病部位位于齒狀線至直腸乙狀結腸交界之間，在我國該病的發病年齡中位數為45歲左右，但是近年來有降低的趨勢[1-4]。直腸癌的治療目前仍以開腹手術為主，雖然腹腔鏡下行微創手術術式已經成熟，但是對于直腸癌的療效，臨床上仍然有爭議[5-6]。為了觀察腹腔鏡與開腹手術在直腸癌臨床療效的比較，該院整群選擇了2014年6月—2015年6月期間該院進行直腸癌手術治療的患者76例進行臨床研究，現報道如下。……