腹腔镜下直肠癌根治术疗效和安全性分析.docVIP

腹腔镜下直肠癌根治术疗效和安全性分析 　　【摘要】 目的 探索腹腔镜手术治疗直肠癌的临床疗效及安全性。方法 60例直肠癌患者按不同手术方案随机分为观察组（腹腔镜手术治疗）36例和对照组（开腹手术治疗）24例， 术后随访1年， 对患者术中各项指标及术后并发症实施观察并记录， 并进行分析比较。结果 观察组手术用时长于对照组（P0.05）；观察组术中出血量、术后肛门首次排气时间及术后住院时间均优于对照组（P0.05）；观察组的术后伤口感染及吻合口瘘发生率明显低于对照组， 差异有统计学意义（P0.05）， 观察组并发症的总发生率明显低于对照组， 差异有统计学意义（P0.05）。结论 腹腔镜用于治疗直肠癌术中出血少， 术后恢复快， 且并发症少， 值得临床推广。 　　【关键词】 腹腔镜手术；直肠癌；开腹手术 　　【Abstract】 Objective To explore the clinical effect and safety of laparoscopic surgery in the treatment of rectal cancer. Methods A total of 60 patients with rectal cancer were divided by different surgical methods into observation group （laparoscopic surgery treatment） with 36 cases and control group （laparotomy treatment） with 24 cases. Follow-up lasted for 1 year after operation. Observation and records were made on intraoperative indexes and postoperative complications for analysis and comparison. Results Operation time was longer in the observation group than in the control group （P0.05）. The observation group had better intraoperative bleeding volume， postoperative first exhaust time， and postoperative hospital stay then the control group （P0.05）. Incidences of postoperative incision infection and anastomotic fistula were much lower in the observation group than in the control group， and their differences had statistical significance （P0.05）. The observation group also had much lower total incidence of complications than the control group， and their difference was statistically significant （P0.05）. Conclusion Implement of laparoscope in rectal cancer surgery has few bleeding， quick postoperative recovery， and few complications. This method is worth clinical promotion. 　　【Key words】 Laparoscopic surgery； Rectal cancer； Laparotomy 　　直肠癌是一类常见的胃肠道恶性肿瘤， 且发病率越来越高。近年来， 经腹腔镜行直肠癌根治术治疗由于术后疼痛轻、切口小、活动早、恢复快， 临床应用越来越广泛。本研究对2012年6月～2014年6月在本院行腹腔镜和开腹直肠癌根治术60例患者的手术情况进行比较， 旨在探索腹腔镜手术治疗直肠癌的临床疗效， 现报告如下。 　　1 资料与方法 　　1. 1 一般资料 选取2012年6月～2014年6月在本院手术治疗的直肠癌患者60例， 均符合《外科学》第7版直肠癌诊断标准[1， 2]， 且经电子肠镜检查明确诊断。男37例， 女23例；年龄26～71岁， 平均年龄（5