中国中西医结合外科杂志
中國中西醫結閤外科雜誌
중국중서의결합외과잡지
CHINESE JOURNAL OF SURGERY OF INTEGRATED TRADITIONAL AND WESTERN MEDICINE
2014年
3期
240-242
,共3页
郭景泉%朱锡元%邹武军%吴莺燕
郭景泉%硃錫元%鄒武軍%吳鶯燕
곽경천%주석원%추무군%오앵연
低位直肠癌%全直肠系膜切除术%腹腔镜%手术方式
低位直腸癌%全直腸繫膜切除術%腹腔鏡%手術方式
저위직장암%전직장계막절제술%복강경%수술방식
Low rectal cancer%total mesorectal excision (TME)%laparoscopic surgery%surgical treatment
目的：比较腹腔镜与开腹手术行低位直肠癌根治术的近期疗效。方法：回顾性分析腹腔镜与开腹手术治疗低位直肠癌患者的临床资料，其中腹腔镜组51例，开腹组48例，比较两组资料在手术时间、术中出血量、肠系膜淋巴结清扫个数、肠道功能恢复时间（记排气时间）、留置导尿时间、进流食时间、术后住院时间、术后并发症发生率之间的差异。结果：腹腔镜与开腹组相比，术中出血量[(61.0±15.0) mL vs (135.8±13.9) mL，P＜0.01]、肠道功能恢复时间[(2.0±0.7) d vs (3.0±0.7) d，P＜0.01]、留置导尿时间[(3.5±1.0) d vs (5.9±1.2) d，P＜0.01]、进流食时间[(3.0±0.9) d vs (4.3±0.9) d, P＜0.01]、住院天数[(8.0±1.3) d vs (10.1±1.8) d, P＜0.01]、并发症发生率（7.8% vs 25%，P＜0.025)，腹腔镜组均少于开腹组。手术时间[(167.1±26.9) min vs (138.6±17.7) min，P＜0.01]及住院费用[(3.3±0.5)万元vs (2.6±0.4)万元，P＜0.01]，腹腔镜组多于开腹组。两组在淋巴结清扫数目上差别无统计学意义[(14.1±1.6) vs (14.3±1.9)，P=0.586]。结论：腹腔镜下低位直肠癌根治术近期疗效优于开腹组。
目的：比較腹腔鏡與開腹手術行低位直腸癌根治術的近期療效。方法：迴顧性分析腹腔鏡與開腹手術治療低位直腸癌患者的臨床資料，其中腹腔鏡組51例，開腹組48例，比較兩組資料在手術時間、術中齣血量、腸繫膜淋巴結清掃箇數、腸道功能恢複時間（記排氣時間）、留置導尿時間、進流食時間、術後住院時間、術後併髮癥髮生率之間的差異。結果：腹腔鏡與開腹組相比，術中齣血量[(61.0±15.0) mL vs (135.8±13.9) mL，P＜0.01]、腸道功能恢複時間[(2.0±0.7) d vs (3.0±0.7) d，P＜0.01]、留置導尿時間[(3.5±1.0) d vs (5.9±1.2) d，P＜0.01]、進流食時間[(3.0±0.9) d vs (4.3±0.9) d, P＜0.01]、住院天數[(8.0±1.3) d vs (10.1±1.8) d, P＜0.01]、併髮癥髮生率（7.8% vs 25%，P＜0.025)，腹腔鏡組均少于開腹組。手術時間[(167.1±26.9) min vs (138.6±17.7) min，P＜0.01]及住院費用[(3.3±0.5)萬元vs (2.6±0.4)萬元，P＜0.01]，腹腔鏡組多于開腹組。兩組在淋巴結清掃數目上差彆無統計學意義[(14.1±1.6) vs (14.3±1.9)，P=0.586]。結論：腹腔鏡下低位直腸癌根治術近期療效優于開腹組。
목적：비교복강경여개복수술행저위직장암근치술적근기료효。방법：회고성분석복강경여개복수술치료저위직장암환자적림상자료，기중복강경조51례，개복조48례，비교량조자료재수술시간、술중출혈량、장계막림파결청소개수、장도공능회복시간（기배기시간）、류치도뇨시간、진류식시간、술후주원시간、술후병발증발생솔지간적차이。결과：복강경여개복조상비，술중출혈량[(61.0±15.0) mL vs (135.8±13.9) mL，P＜0.01]、장도공능회복시간[(2.0±0.7) d vs (3.0±0.7) d，P＜0.01]、류치도뇨시간[(3.5±1.0) d vs (5.9±1.2) d，P＜0.01]、진류식시간[(3.0±0.9) d vs (4.3±0.9) d, P＜0.01]、주원천수[(8.0±1.3) d vs (10.1±1.8) d, P＜0.01]、병발증발생솔（7.8% vs 25%，P＜0.025)，복강경조균소우개복조。수술시간[(167.1±26.9) min vs (138.6±17.7) min，P＜0.01]급주원비용[(3.3±0.5)만원vs (2.6±0.4)만원，P＜0.01]，복강경조다우개복조。량조재림파결청소수목상차별무통계학의의[(14.1±1.6) vs (14.3±1.9)，P=0.586]。결론：복강경하저위직장암근치술근기료효우우개복조。
Objective To compare the recent curative effect of laparoscopy and open surgery for low rectal cancer. Methods Retrospective analysis on the clinical data of laparoscopy and open surgery for low rectal cancer in our hospital between January 2009 and December 2012. Laparoscopic group have 51 cases , 48 cases are in the open group.Peri-operative indexes and results of postoperative follow-up were compared between the two groups. The data of the two groups were compared in the operation time, intraoperative blood loss, number of removed mesenteric lymph nodes , the intestinal function recovery time(Record the fart time), urinary reten-tion time,eating flow food time,postoperative hospitalization time, and the difference between the incidence of postoperative complications. Results As compared to the open surgery group,the laparoscopy group had sig-nificantly less blood loss[(61.0 ± 15.0) mL VS (135.8 ± 13.9) mL,P<0.01],shorter gastrointestinal recovery time [(2.0 ± 0.7) d VS (3.0 ± 0.7) d,P <0.01],shorter urinary retention time[(3.5 ± 1.0) d VS (5.9 ± 1.2) d,P <0.01], shorter eating flow food time[(3.0 ± 0.9) d VS (4.3 ± 0.9) d,P <0.01], shorter hospitalization time[(8.0 ± 1.3) d VS (10.1± 1.8) d,P<0.01], longer operative time[(167.1 ± 26.9) min VS (138.6 ± 17.7) min,P<0.01], higher hos-pitalization cost[(3.3 ± 0.5) VS (2.6 ± 0.4) the thousand yuan,P <0.01] . The incidence of complications of lapa-roscopy group was lower than open surgery group(7.8% vs 25%,P < 0.05).No significant difference existed in the number of resected lymph notes between the two groups( 14.1 ± 1.6 vs14.3 ± 1.9,P = 0.586). Conclusion Laparoscopy for low rectal cancer has more advantages than open surgery in the recent curative effect.
