CAJ | 학술논문

目的：通过手助腹腔镜与开腹下直肠癌根治术的对比研究，评估手助腹腔镜在直肠癌根治手术中应用的优劣。方法对本院103例接受手助腹腔镜和开腹手术的直肠癌患者的基本临床资料、手术切口、术中出血、手术时间、术后恢复、病理结果、近期疗效等进行分析。结果两组患者的基本临床资料无统计学差异，手助腹腔镜组的手术切口长度、手术出血量、术后住院天数、术后镇痛、术后排气时间等方面明显优于开腹组，两组在手术时间、术后并发症发生率等方面无统计学差异。术后两组患者平均随访26个月，各自出现2例远处转移及复发，无切口种植情况。结论手助腹腔镜直肠癌根治术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：통과수조복강경여개복하직장암근치술적대비연구，평고수조복강경재직장암근치수술중응용적우렬。방법대본원103례접수수조복강경화개복수술적직장암환자적기본림상자료、수술절구、술중출혈、수술시간、술후회복、병리결과、근기료효등진행분석。결과량조환자적기본림상자료무통계학차이，수조복강경조적수술절구장도、수술출혈량、술후주원천수、술후진통、술후배기시간등방면명현우우개복조，량조재수술시간、술후병발증발생솔등방면무통계학차이。술후량조환자평균수방26개월，각자출현2례원처전이급복발，무절구충식정황。결론수조복강경직장암근치술시안전적미창수술방식，도구유주원시간단、진식급장도회복쾌，동통감경，출혈량교소，수술철저성량호적특점。
Objective This prospective ,randomized study compared the outcomes of hand-assisted laparoscopic surgery ( HALS) with open approach resection of rectal carcionma .Methods 103 rectal cancer patients received HALS and open approach surgery .The main outcome measures were the distance of tumor to anus,procedure time,blood loss,length of abdominal incision ,post-operative abdominal drainage ,return of bowel function ,length of hospital stay ,morbidity and pathology results .Results Patients in each group were similar with regard to general status and the histopathological features of tumours .Length of abdominal incision,surgical blood loss,post-operative hospital stay length ,mean duration of narcotic analgesia ,time to first passing flatus , and postoperative venous high nutrition application were better in HALS than open approach surgery .Procedure times and post-operative morbidity were similar in two group .At a median follow-up of 26 months, both of the groups occured two recurrences .Conclusion In this study , the HALS and laparoscopic surgery approaches for curative resection of rectal carcinoma was safe and effective and may offer several potential advantages to patients in their post-operative recovery .