CAJ | 학술논문

目的：通过手助腹腔镜与腹腔镜直肠癌根治术的对比研究，了解两种手术方式的的临床应用价值。方法对比手助腹腔镜和腹腔镜手术的直肠癌患者各52例的基本临床资料、手术切口、术中出血量、手术时间、术后恢复、病理结果、近期疗效等，并进行统计学分析。结果手助腹腔镜组平均手术时间明显优于腹腔镜组，平均切口长度长于腹腔镜组，平均出血量多于腹腔镜组，差异均有统计学意义（P＜0.05或0.01）。两组在术后平均止痛时间、术后静脉高营养使用时间、术后平均引流量、术后排气时间、术后进食流质时间等方面并无统计学差异（均P＞0.05），手助腹腔镜组患者术后平均住院时间短于腹腔镜组，差异有统计学意义（P＜0.01）。结论腹腔镜与手助腹腔镜直肠癌根治术都是安全的微创手术方式，都具有住院时间短、进食及肠道恢复快，疼痛减轻，出血量较少，手术彻底性良好的特点。
목적：통과수조복강경여복강경직장암근치술적대비연구，료해량충수술방식적적림상응용개치。방법대비수조복강경화복강경수술적직장암환자각52례적기본림상자료、수술절구、술중출혈량、수술시간、술후회복、병리결과、근기료효등，병진행통계학분석。결과수조복강경조평균수술시간명현우우복강경조，평균절구장도장우복강경조，평균출혈량다우복강경조，차이균유통계학의의（P＜0.05혹0.01）。량조재술후평균지통시간、술후정맥고영양사용시간、술후평균인류량、술후배기시간、술후진식류질시간등방면병무통계학차이（균P＞0.05），수조복강경조환자술후평균주원시간단우복강경조，차이유통계학의의（P＜0.01）。결론복강경여수조복강경직장암근치술도시안전적미창수술방식，도구유주원시간단、진식급장도회복쾌，동통감경，출혈량교소，수술철저성량호적특점。
Objective To compare the outcomes of hand- assisted laparoscopic surgery (HALS) and laparoscopic surgery (LS) for radical resection of rectal carcinoma. Methods One hundred and four patients with rectal cancer were random-ized to receive HALS (n=52) or LS (n=52) for radical resection of rectal carcinoma. The main outcome measures were procedure time, blood loss, length of abdominal incision, post- operative abdominal drainage, return of bowel function, length of hospital stay, morbidity and pathological results. Results There were no significant differences in mean duration of analgesia, post- op-erative abdominal drainage, time to first passing flatus and postoperative venous high nutrition application between two groups. Procedure times and length of post- operative hospital stay were significantly shorter in HALS group. However, the length of ab-dominal incision and surgical blood loss were significantly shorter in LS group than those in HALS group. During a median fol-low- up of 26 months, there were two cases of recurrence in each group. Conclusion The study shows that both the HALS and LS are safe and effective approaches with certain advantages for patients with rectal carcinoma.