腹腔镜与开腹TME手术治疗中低位直肠癌的临床疗效对比研究.docVIP

精品论文 参考文献 腹腔镜与开腹TME手术治疗中低位直肠癌的临床疗效对比研究 张有缘 　　（成都川办医院 611430） 　　【摘要】目的：比较腹腔镜与开腹全直肠系膜切除（TME）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TME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。 　　【关键词】腹腔镜 TME 直肠癌 临床疗效 　　【中图分类号】R730.5 【文献标识码】A 【文章编号】1672-5085（2014）08-0079-02 　　Clinical outcomes of laparoscopic total mesorectal excision compared to open surgery in patients with middle and low rectal cancers 　　【Abstract】 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. 　　【Key words】Laparoscopic surgery Total mesorectal excision Rectal cancers Clinical outcome 　　随着生活方式的转变，我国结直肠肿瘤的发病率逐年升高。据统计，我国结直肠癌的发病率约为3.1/10万～10.7/10万，直肠癌所占的比例可达70%,其中中低位直肠癌的比例可达70%～80%[1]。近年来，随着全直肠系膜切除（TME）、腹腔镜技术以及辅助放化疗技术逐步推广，直肠癌的