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目的比较直肠癌腹腔镜与开腹全系膜切除术的远期疗效和近期并发症。方法回顾性分析2007年2月至2010年3月间接受手术治疗的116例直肠癌患者的临床资料。行腹腔镜直肠癌全系膜切除术的64例患者作为腹腔镜组,行传统开腹直肠癌全系膜切除术的52例患者作为开腹组,比较两组患者近期并发症和远期疗效。结果两组患者清扫淋巴结数目、术后排气时间、引流管拔除时间和住院费用的差异均无统计意义(均P>0.05)。腹腔镜组患者的术中出血量、术后3 d内腹腔引流量、术中住院时间均明显少于开腹组,而出院满意度高于开腹组,差异均有统计学意义(均P<0.05)。腹腔镜组患者的5年无病生存率明显高于开腹组,差异有统计学意义(P<0.05)。结论与传统直肠癌根治术相比,腹腔镜手术能更有效地改善患者的预后,提高患者的生活质量。
Objective To compare the long-term efficacy and recent complications of laparoscopic and open total mesorectal excision for rectal cancer. Methods The clinical data of 116 rectal cancer patients undergoing surgery between February 2007 and March 2010 were retrospectively analyzed. Sixty-four cases of laparoscopic total mesorectal excision as a laparoscopic group underwent open radical resection of the total mesorectal excision of 52 patients as an open group to compare the two groups of patients with short-term complications and long-term efficacy . Results There were no significant differences in the number of lymph nodes dissection, postoperative exhaust time, drainage tube removal time and hospitalization costs between the two groups (all P> 0.05). The intraoperative blood loss in laparoscopic group, intra-abdominal drainage volume and intraoperative hospital stay were significantly less than those in open group within 3 days after operation, but the discharge satisfaction was higher than that in open group (P <0.05). The 5-year disease-free survival rate of patients in laparoscopic group was significantly higher than that in open group, the difference was statistically significant (P <0.05). Conclusion Compared with the traditional radical resection of rectal cancer, laparoscopic surgery can more effectively improve the prognosis of patients and improve the quality of life of patients.