CAJ | 학술논문

目的：探讨微创镜技术在老年直肠癌根治术中的临床应用价值。方法：将240例老年直肠癌患者随机分为腹腔镜组和开腹组，各120例。开腹组患者行传统开腹直肠癌全系膜切除术，腹腔镜组行腹腔镜下直肠癌根治术。比较两组患者的围手术期情况、术后近期并发症发生情况和术后随访情况。结果：腹腔镜组的手术时间、术中失血量、术后镇痛率、排气时间和住院时间均明显低于开腹组，差异均有统计学意义（P<0.01或0.05）；腹腔镜组和开腹组术后并发症发生率分别为15.0%和49.2%，差异有统计学意义（P<0.001）；两组患者局部复发率、远处转移率和5年总生存率比较差异均无统计学意义（P>0.05）。结论：相对开腹手术而言，腹腔镜直肠癌根治术具有更好的短期疗效，且两者远期疗效相当，有望成为老年直肠癌患者常规外科治疗方法，值得临床推广应用。
목적：탐토미창경기술재노년직장암근치술중적림상응용개치。방법：장240례노년직장암환자수궤분위복강경조화개복조，각120례。개복조환자행전통개복직장암전계막절제술，복강경조행복강경하직장암근치술。비교량조환자적위수술기정황、술후근기병발증발생정황화술후수방정황。결과：복강경조적수술시간、술중실혈량、술후진통솔、배기시간화주원시간균명현저우개복조，차이균유통계학의의（P<0.01혹0.05）；복강경조화개복조술후병발증발생솔분별위15.0%화49.2%，차이유통계학의의（P<0.001）；량조환자국부복발솔、원처전이솔화5년총생존솔비교차이균무통계학의의（P>0.05）。결론：상대개복수술이언，복강경직장암근치술구유경호적단기료효，차량자원기료효상당，유망성위노년직장암환자상규외과치료방법，치득림상추엄응용。
Objective:To investigate the clinical value of minimally invasive technique in radical operation of rectal cancer in the elderly.Method:A total of 240 cases of the elderly rectal cancer were randomly divided into the laparoscopic and laparotomic groups,each of 120 cases. The latter underwent open total mesorectal excision of rectal cancer while the former did laparoscopic radical resection of rectal cancer.The perioperative situation,postoperative short-term complications and follow-up of two groups were compared. Result:The operation time,perioperative blood loss, postoperative analgesia,exhaust time and hospital length in the laparoscopic groups were lower significantly than those in the open group(P<0.01 or P<0.05).The incidences of postoperative complications were 15%and 49.2%respectively (P<0.001).There were no significant differeces in local recurrence rate,distant metastasis rate and total survival rate of 5 years(P>0.05).Conclusion:Compared with the laparotomy,the laparoscopic radical resection of rectal cancer posseses the better short-term efficacy,with the same the long-term efficacy,prosmosing the routine surgical method for the elderly rectal caner patients and deserving the clinical use extensively.