腹腔镜下直肠癌根治术的近期临床疗效观察

Short-term clinical efficacy observation of laparoscopic radical resection for rectal cancer
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    摘要:

    目的 探讨腹腔镜下直肠癌根治术的近期临床疗效。方法 回顾性分析2015 年11 月-2016 年11 月该院行直肠癌根治性手术的患者50 例。其中,行腹腔镜下直肠癌根治术的患者27 例,行开腹直肠癌根治 术的患者23 例,观察两组患者手术时间、肿瘤直径、标本切除长度、术中清扫淋巴结数目、开始下床活动时 间、术后肛门排气时间、术后的排便时间、术后开始进食时间和术后并发症等指标。结果 腹腔镜组患者的 肿瘤直径、标本切除长度和淋巴结清扫数目为(3.8±1.4)cm、(18.5±2.1)cm 和(7.2±3.1)枚,而开腹组 患者相应检查项目分别为(3.9±1.4)cm、(18.6±2.3)cm 和(7.7±3.4)枚,组间比较差异不具统计学意义 (P >0.05)。腹腔镜组患者在术中出血量、手术时间、术后下床活动时间、术后肛门排气时间、术后排便时间、 术后进食流质食物时间和术后住院时间分别为(105.3±23.8)ml、(140.2±22.3)min、(4.0±1.2)d、(6.0±1.5)d、 (3.0±1.0)d、(3.5±0.5)d 和(4.0±1.0)d, 开腹组相应数值为(210.4±21.3)ml、(118.9±20.7)min、 (4.5±1.1)d、(7.8±1.2)d、(7.0±1.6)d、(8.1±2.0)d 和(10.0±3.2)d,两组患者的比较差异有统计学意 义(P <0.05)。结论 腹腔镜下直肠癌根治性手术安全有效,可以对肿瘤做到根治性切除,且术中出血少,术 后康复快,住院时间短。

    Abstract:

    Objective To discuss the short-term clinical curative effect of laparoscopic colorectal cancer radical resection for rectal cancer. Methods Clinical data of 50 patients with rectal cancer underwent radical resection from November 2015 to November 2016 were retrospectively analyzed. Among them, 27 cases underwent laparoscopic radical resection (Laparoscopy group), the other 23 cases underwent radical resection (Laparotomy group). Then observe and record the operation time, tumor diameter, specimen length, number of lymph node cleaning, time of ambulation, postoperative anal exhaust time, postoperative defecation time, postoperative complications and postoperative eating time of the two groups. Results The tumor diameter, length of specimens and number of lymph node dissection in laparoscopic group were (3.8 ± 1.4) cm, (18.5 ± 2.1) cm and (7.2 ± 3.1), while in Laparotomy group were (3.9 ± 1.4) cm, (18.6 ± 2.3) cm, and (7.7 ± 3.4), the difference has no statistical significance (P > 0.05). The intraoperative blood loss, operation time, ambulation time, postoperative anal exhaust time, postoperative defecation time, postoperative eating liquid diet time, postoperative hospitalization time in laparoscopic group were (105.3 ± 23.8) ml, (140.2 ± 22.3) min, (4.0 ± 1.2) d, (6.0 ± 1.5) d, (3.0 ± 1.0) d, (3.5 ± 0.5) d and (4.0 ± 1.0) d, while in Laparotomy group were (210.4 ± 21.3) ml, (118.9 ± 20.7) min, (4.5 ± 1.1) d, (7.8 ± 1.2) d, (7.0 ± 1.6) d, (8.1 ± 2.0) d and (10.0 ± 3.2) d, there was significant difference between the two groups (P < 0.05). Conclusion Laparoscopicsurgery for rectal cancer is safe and effective. It can achieve radical tumor resection, and intraoperative less bleeding, faster postoperative recovery, shorter hospitalization time.

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    [1] 卫洪波, 郑宗珩. 腹腔镜保留盆腔自主神经的直肠癌根治术技 术要领[J]. 中华胃肠外科杂志, 2015, 18(6): 529-532. WEI H B, ZHENG Z H. Techniques of autonomic nerve preservation in laparoscopic radical resection for rectal cancer [J]. Chinese Journal of Gastrointestinal Surgery, 2015, 18(6): 529-532. Chinese
    [2] 鞠海星, 黄新, 朱玉萍, 等. 手辅助腹腔镜和腹腔镜及开腹直肠 癌根治术的近期疗效比较[J]. 中华胃肠外科杂志, 2014, 17(6): 574-577.
    [2] JU H X, HUANG X, ZHU Y P, et al. The short-term effect of hand assisted laparoscopic and laparoscopic radical resection for rectal cancer[J]. Chinese Journal of Gastrointestinal Surgery, 2014, 17(6): 574-577. Chinese
    [3] 卫洪波, 魏波, 郑宗珩. 腹腔镜直肠癌根治术—Denonvilliers 筋 膜保留与否: 保留Denonvilliers 筋膜的价值与可行性[J]. 中华 胃肠外科杂志, 2015, 18(8): 773-776.
    [3] WEI H B, WEI B, ZHENG Z H. Should Denonvilliers’ fascia be preserved during laparoscopic radical surgery for rectal cancer? Value and feasibility of preserving Denonvilliers’ fascia[J]. Chinese Journal of Gastrointestinal Surgery, 2015, 18(8): 773-776. Chinese
    [4] 秦长江, 李全营, 傅侃达, 等. 腹部无辅助切口腹腔镜直肠癌根 治术的应用体会[J]. 中华胃肠外科杂志, 2014, 17(5): 486-488.
    [4] QIN C J, LI Q Y, FU K D, et al. Experiences of scarless laparoscopic radical resection of rectal cancer[J]. Chinese Journal of Gastrointestinal Surgery, 2014, 17(5): 486-488. Chinese
    [5] 李世拥, 陈纲, 杜峻峰, 等. 腹部无切口经肛门切除标本的腹腔 镜低位直肠癌根治套入式吻合保肛术[J]. 中华胃肠外科杂志, 2015, 18(6): 581-583.
    [5] LI S Y, CHEN G, DU J F, et al. Transanal laparoscopic radical resection with telescopic anastomosis for low rectal cancer[J]. Chinese Journal of Gastrointestinal Surgery, 2015, 18(6): 581-583. Chinese
    [6] 曾庆敏, 王延召, 黄文生, 等. 3D 与2D 腹腔镜直肠癌根治术 近期疗效的观察[J]. 中国普通外科杂志, 2016, 25(4): 622-626.
    [6] ZENG Q M, WANG Y Z, HUANG W S, et al. Observation of the short-term effect of 3D and 2D laparoscopic radical resection of rectal cancer[J]. Chinese Journal of General Surgery, 2016, 25(4): 622-626. Chinese
    [7] 唐超明, 蔡灿峰, 陈国星. 腹腔镜技术在不同分期直肠癌根治 术中应用的安全性分析[J]. 中华胃肠外科杂志, 2015, 18(6): 568-572.
    [7] TANG C M, CAI C F, CHEN G x. Oncologic safety of laparoscopic surgery in radical resection for different stage rectal cancer[J]. Chinese Journal of General Surgery, 2015, 18(6): 568-572. Chinese
    [8] 费秉元, 姜俊男, 房学东, 等. 3D 与2D 腹腔镜直肠癌根治术的 疗效分析[J]. 中华消化外科杂志, 2016, 15(8): 785-788.
    [8] FEI B Y, JIANG J N, FANG X D, et al. Effect analysis of three dimensional and two-dimensional imaging systems in laparoscopic radical resection of rectal cancer[J]. Journal of Digestive Surgery, 2016, 15(8): 785-788. Chinese
    [9] 杨庆强, 唐春燕, 徐亮. 腹腔镜直肠癌根治术疗效分析[J]. 中国 内镜杂志, 2014, 20(7): 748-751.
    [9] YANG Q Q, TANG C Y, XU L. Effect analysis of laparoscopic radical resection for rectal cancer[J]. China Journal of Endoscopy, 2014, 20(7): 748-751. Chinese
    [10] 钱祖超, 张群, 罗华梁. 盐酸羟考酮用于腹腔镜直肠癌根治 术患者镇痛效果的观察[J]. 中国临床药理学与治疗学, 2015, 20(5): 587-590.
    [10] QIAN Z C, ZHANG Q, LUO H L. To observe the curative effect of oxycodone hydrochloride in patients undergoing laparoscopic[J]. China Analgesia Clinical Pharmacology and Therapeutics, 2015, 20(5): 587-590. Chinese
    [11] The Clinical Outcomes of Surgical Therapy Study Group. A comparison of laparoscopically assisted and open colectomy for colon cancer[J]. N Engl J Med, 2004, 350(20): 2050-2059.
    [12] 荣维淇, 王黎明, 周志祥, 等. 结直肠癌开腹与腹腔镜下手术 疗效的前瞻性研究[J]. 中国肿瘤临床, 2009, 36(10): 559-563.
    [12] RONG W Q, WANG L M, ZHOU Z X, et al. Prospective study of open and laparoscopic surgery for colorectal cancer[J]. Chinese journal of Clinical Oncology, 2009, 36(10): 559-563. Chinese
    [13] 施小龙, 池畔, 林惠铭. 腹腔镜下结直肠癌根治术疗效分析[J]. 中华消化外科杂志, 2010, 9(3): 207-209.
    [13] SHI X L, CHI P, LIN H M. Analysis of curative effect of laparoscopic radical resection for colorectal cancer[J]. Chinese Journal of Digestive Surgery, 2010, 9(3): 207-209. Chinese
    [14] BREUKINK S O, PIERIE J P, GROND A J, et al. Laparoscopic versus open total mesorectal excision: a case-control study[J]. Int J Colorectal Dis, 2005, 20(5): 428-433.
    [15] FRASSON M, BRAGA M, VIGNALI A, et al. Laparoscopicassisted versus open surgery for colorectal cancer:postoperative morbidity in a single center randomized trial[J]. Minerva Chir, 2006, 61(4): 283-292.
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田雪梅,罗斌,曹勍,任娅宁.腹腔镜下直肠癌根治术的近期临床疗效观察[J].中国内镜杂志,2017,23(7):50-53

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  • 收稿日期:2017-01-18
  • 在线发布日期: 2017-07-30
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