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目的分析肥胖对腹腔镜直肠癌根治手术结果的影响,探讨肥胖直肠癌患者行腹腔镜手术治疗的可行性。方法回顾性分析160例腹腔镜辅助直肠癌根治术患者的临床资料,将所有患者按体重指数(BMI)分为肥胖组(BMI≥28kg/m2)、超重组(BMI 24～27.9kg/m2)和正常体重组(BMI<24 kg/m2),对比分析3组患者的手术结果。结果 3组患者手术均达到肿瘤根治性切除标准,肥胖组、超重组和正常体重组平均淋巴结清扫数目分别为14.7个、14.0个和16.5个,远端切缘长度分别为2.7cm、3.2cm和3.1cm,差异均无统计学意义(P>0.05);中转开腹率3组分别为12.5%、9.7%和6.8%(P=0.651),3组手术时间差异无统计学意义(P>0.05);3组总的并发症发生率结果相似。结论肥胖对腹腔镜直肠癌根治术的中转开腹率、手术时间、并发症发生率及手术的根治性效果未产生显著影响,肥胖直肠癌患者可以接受腹腔镜手术治疗。
Objective To analyze the effect of obesity on the results of laparoscopic radical resection of rectal cancer and to explore the feasibility of laparoscopic surgery in patients with obesity and rectal cancer. Methods The clinical data of 160 patients undergoing laparoscopic radical resection of rectal cancer were retrospectively analyzed. All patients were divided into obesity group (BMI≥28kg / m2) and overweight group (BMI 24 ~ 27.9kg / m2) by body mass index (BMI) And normal weight group (BMI <24 kg / m2). The surgical results of three groups were compared. Results All three groups of patients underwent radical resection. The average number of lymph node dissections in obese, overweight and normal weight groups were 14.7, 14.0 and 16.5, respectively. The distal margin length was 2.7cm, 3.2cm and (P> 0.05). The rates of laparotomy in the three groups were 12.5%, 9.7% and 6.8% respectively (P = 0.651), there was no significant difference in the operation time between the three groups (P> 0.05 ); The overall complication rates in 3 groups were similar. Conclusions Obesity has no significant effect on the conversion rate of laparoscopic radical mastectomy, the time of operation, the complication rate and the curative effect of laparoscopic radical resection of rectal cancer. The patients with obesity and rectal cancer can receive laparoscopic surgery.