摘要
目的探讨腹腔镜全直肠系膜切除术(total mesorectal excision,T'ME)治疗直肠癌的临床疗效。方法回顾分析2005年6月—2010年6月由同一手术组完成的腹腔镜TME 209例和开腹TME 143例患者的临床资料,以评价2组患者的远期生存率及术后并发症等。结果腹腔镜组和开腹组患者出血量分别为(66±21)mL和(170±92)mL(t=15.71,P<0.05),术后排气时间分别为(2.9±2.5)d和(3.9±2.6)d(t=3.63,P<0.05),术后住院时间分别为(10.2±4.7)d和(13.8±5.9)d(t=6.35,P<0.05),腹腔镜组明显少于开腹组。2组患者淋巴结清扫数和直肠肿瘤远端切缘比较差异无统计学意义(P>0.05)。3、5年生存率腹腔镜组分别是80.8%和62.9%,开腹组分别是80.5%和60.0%,2组术后生存率差异无统计学意义(P>0.05)。开腹组术后切口感染发生机会多于腹腔镜组,2组患者吻合口瘘发生率基本相同(P均>0.05)。结论腹腔镜直肠癌全系膜切除术手术安全,创伤小,恢复快,远期疗效与开腹手术相近。
Objective To study the efficacy of laparoscopic total mesorectal excision （TME） in treating rectal cancer. Methods A retrospective comparison was made between 209 cases undergoing laparoscopic TME and 143 cases undergoing open TME during the period of June 2005 to June 2010 to compare the long - term survival and complications between the two grougs. Results The intraoperative blood loss of laparoscopie group was obviously less than that in open group （66 ±21 ）mL vs （170 ± 92 ） mL, （t = 15.71, P 〈 0.05 ）. The time of passage of gas were significantly shorter than those in open group （2. by anus and hospital stay in laparoscopic group 9 ±2.5）d vs （3.9 ±2.6） d, （t = 3.63,P 〈 0. 05 ） ; （ 10.2 ± 4.7） d vs （ 13.8 ± 5.9 ） d （ t = 6.35, P 〈 0.05 ）. No significant difference was observed between the two groups in the lymph nodes clearance and distal margin. The 3 and 5 - year - survival rate was 84.5% and 66.7% in laparoscopic group,83.3% and 64.8% in traditional operation group with no significant difference by Life - table method. The infection of incision was more likely to occur in open group than in laparoscopic group. The rates of anastomotic leakage was almost same in the two groups. Conclusion Laparoscopic TME is a safe technique with minimal trauma and better recovery for patients with rectal cancer which can get the same long -term effect as open procedure.
出处
《河北医科大学学报》
CAS
2012年第1期36-38,共3页
Journal of Hebei Medical University
关键词
直肠肿瘤
腹腔镜检查
治疗结果
rectal neoplasms
laparoscopy
treatment outcome
