CAJ | 학술논문

目的：比较腹腔镜与开腹全直肠系膜切除（T M E）手术治疗中低位直肠癌的临床疗效。方法：选取本院2009年1月至2013年12月接收的106例中低位直肠癌患者，随机分为腹腔镜组和开腹组，比较两组患者术中各项指标、肿瘤治疗情况、术后恢复情况及术后并发症等指标。结果：两组患者相比较，腹腔镜组手术用时相对长，术中失血量及保留肛门括约肌率要优于开腹组，两组间差异有统计学意义（P＜0.05）；术后镇痛时间、留置尿管时间、肛门排气时间及术后住院天数等指标，腹腔镜组均少于开腹组，两组间差异有统计学意义（P＜0.05）；肿瘤治疗情况：切除标本长度、淋巴结清除数和切缘阳性率等，两组间差异无统计学意义（P＞0.05）；术后并发症两组间差异无统计学意义（P＞0.05）。结论：腹腔镜T M E手术是安全、微创且有效的，具有与开腹手术相同的肿瘤治疗效果。
목적：비교복강경여개복전직장계막절제（T M E）수술치료중저위직장암적림상료효。방법：선취본원2009년1월지2013년12월접수적106례중저위직장암환자，수궤분위복강경조화개복조，비교량조환자술중각항지표、종류치료정황、술후회복정황급술후병발증등지표。결과：량조환자상비교，복강경조수술용시상대장，술중실혈량급보류항문괄약기솔요우우개복조，량조간차이유통계학의의（P＜0.05）；술후진통시간、류치뇨관시간、항문배기시간급술후주원천수등지표，복강경조균소우개복조，량조간차이유통계학의의（P＜0.05）；종류치료정황：절제표본장도、림파결청제수화절연양성솔등，량조간차이무통계학의의（P＞0.05）；술후병발증량조간차이무통계학의의（P＞0.05）。결론：복강경T M E수술시안전、미창차유효적，구유여개복수술상동적종류치료효과。
AIM: To investigate the clinical outcomes of laparoscopic total mesorectal excision compared to open surgery in patients with middle and low rectal cancers. METHODS:106 patients with middle and low rectal cancer were randomly assigned to either the laparoscopic TME group or the open TME group between January 2009 and December 2013 at our hospital. Clinical outcomes were compared in those two groups, such as operative information, post surgery recovery and oncological outcomes. RESULTS: Compared to open surgery, laparoscopic surgery have longer operating time, less blood lose and more sphincter-preserving. Concerning postoperative analgesia, duration of urinary drainage, time to pass flatus and postoperative hospital stay, laparoscopic surgery has more benefits. The complication rate, circumferential margin involvement, distal margins and lymph node yield were similar for both procedures. CONCLUSION: Laparoscopic TME is safe, minimal invasive and effective, with an oncological adequacy comparable to the open approach.