手助腹腔镜与开腹低位直肠癌切除术疗效分析(1)
[摘要] 目的 探讨手助腹腔镜与开腹低位直肠癌切除术疗效情况。方法 整群选取并分析广东省湛江中心人民医院2012年9月—2015年9月诊治的350例低位直肠癌患者临床资料，依据治疗措施不同进行分组，手助腹腔镜组200例和开腹组150例。观察两组低位直肠癌患者手术时间、术中出血量、排气时间、留置尿管时间、进食流质时间、术后住院时间情况。观察两组低位直肠癌患者术后并发症情况。结果 手助腹腔镜组低位直肠癌患者手术时间(165.6±14.8)min高于开腹组(138.5±12.3)min，手助腹腔镜组低位直肠癌患者术中出血量(61.5±10.4)ml、排气时间(2.0±0.5)d、留置尿管时间(3.4±1.2)d、进食流质时间(3.1±0.6)d、术后住院时间(8.1±1.2)d均低于开腹组(136.8±12.9)ml、(3.0±0.6)d、(5.9±1.4)d、(4.4±0.8)d、(10.2±1.9)d，手助腹腔镜组低位直肠癌患者术后并发症0%低于开腹组18.7%，差异有统计学意义(P<0.05)。结论 手助腹腔镜低位直肠癌切除术创伤小，恢复快，值得临床推广应用。
[关键词] 手助腹腔镜；开腹；低位直肠癌切除术
[中图分类号] R735.37 [文献标识码] A [文章编号] 1674-0742(2016)05(b)-0026-03
[Abstract] Objective To discuss the curative effect of hand-assisted laparoscopic surgery and open resection for low rectal cancer. Methods The clinical data of 350 cases of patients with low rectal cancer treated in our hospital from September 2012 to September 2015 were analyzed， and the patients were divided into the hand-assisted laparoscopic surgery group with 200 cases and the laparotomy group with 150 cases according to the different treatment measures， and the operation time， intraoperative blood loss， exhaust time， indwelled urinary catheter time， eating liquid time and postoperative length of stay of the two groups were observed， and the postoperative complications of the two groups were observed. Results The operation time in the hand-assisted laparoscopic surgery group was higher than that in the laparotomy group，[(165.6±14.8) min vs(138.5±12.3) min]， the intraoperative blood loss， exhaust time， indwelled urinary catheter time， eating liquid time and postoperative length of stay in the hand-assisted laparoscopic surgery group were lower than those in the laparotomy group，[(61.5±10.4) ml， (2.0±0.5) d， (3.4±1.2) d， (3.1±0.6) d， (8.1±1.2) d vs (136.8±12.9) ml， (3.0±0.6) d， (5.9±1.4) d， (4.4±0.8) d， (10.2±1.9) d]， and the incidence rate of postoperative complications in the hand-assisted laparoscopic surgery group was lower than that in the laparotomy group (0 vs 18.7%)， and all differences had statistical significance(P<0.05). Conclusion The hand-assisted laparoscopic surgery has small trauma and rapid recovery， which is worth clinical promotion and application.
[Key words] Hand-assisted laparoscopic surgery； Laparotomy； Resection for low rectal cancer
低位直肠癌是临床常见的恶性肿瘤，其主要是指距离肛缘8 cm以内的直肠癌，具有复发率高、患者预后差等特点[1]。目前手术切除是临床治疗低位直肠癌有效治疗措施，随着手术技术的不断发展，除了传统的开腹低位直肠癌切除术，手助腹腔镜低位直肠癌切除术的应用也明显增多[2]。该研究通过对该院2012年9月—2015年9月收治的350例低位直肠癌患者临床资料进行分析，拟探讨手助腹腔镜与开腹低位直肠癌切除术疗效情况，现报道如下。 (陈文 吴雄辉)
[关键词] 手助腹腔镜；开腹；低位直肠癌切除术
[中图分类号] R735.37 [文献标识码] A [文章编号] 1674-0742(2016)05(b)-0026-03
[Abstract] Objective To discuss the curative effect of hand-assisted laparoscopic surgery and open resection for low rectal cancer. Methods The clinical data of 350 cases of patients with low rectal cancer treated in our hospital from September 2012 to September 2015 were analyzed， and the patients were divided into the hand-assisted laparoscopic surgery group with 200 cases and the laparotomy group with 150 cases according to the different treatment measures， and the operation time， intraoperative blood loss， exhaust time， indwelled urinary catheter time， eating liquid time and postoperative length of stay of the two groups were observed， and the postoperative complications of the two groups were observed. Results The operation time in the hand-assisted laparoscopic surgery group was higher than that in the laparotomy group，[(165.6±14.8) min vs(138.5±12.3) min]， the intraoperative blood loss， exhaust time， indwelled urinary catheter time， eating liquid time and postoperative length of stay in the hand-assisted laparoscopic surgery group were lower than those in the laparotomy group，[(61.5±10.4) ml， (2.0±0.5) d， (3.4±1.2) d， (3.1±0.6) d， (8.1±1.2) d vs (136.8±12.9) ml， (3.0±0.6) d， (5.9±1.4) d， (4.4±0.8) d， (10.2±1.9) d]， and the incidence rate of postoperative complications in the hand-assisted laparoscopic surgery group was lower than that in the laparotomy group (0 vs 18.7%)， and all differences had statistical significance(P<0.05). Conclusion The hand-assisted laparoscopic surgery has small trauma and rapid recovery， which is worth clinical promotion and application.
[Key words] Hand-assisted laparoscopic surgery； Laparotomy； Resection for low rectal cancer
低位直肠癌是临床常见的恶性肿瘤，其主要是指距离肛缘8 cm以内的直肠癌，具有复发率高、患者预后差等特点[1]。目前手术切除是临床治疗低位直肠癌有效治疗措施，随着手术技术的不断发展，除了传统的开腹低位直肠癌切除术，手助腹腔镜低位直肠癌切除术的应用也明显增多[2]。该研究通过对该院2012年9月—2015年9月收治的350例低位直肠癌患者临床资料进行分析，拟探讨手助腹腔镜与开腹低位直肠癌切除术疗效情况，现报道如下。 (陈文 吴雄辉)