腹腔镜与开腹手术治疗直肠癌临床疗效观察
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摘要
目的观察在新辅助化疗下应用腹腔镜直肠癌根治术和常规开腹手术治疗直肠癌的临床疗效。方法选取120例直肠癌患者,随机分为两组,均行新辅助化疗,研究组采用腹腔镜直肠癌根治术,对照组采用开腹手术。比较两组患者手术相关基本情况;比较两组患者的术后并发症;比较两组患者术后伤口疼痛程度。结果两组肿瘤下缘距远切端长度、淋巴结清扫数目比较,差异无统计学意义(P>0.05),研究组手术时间、术中出血量、术后首次排气时间、住院时间、切口总长度小于对照组,差异有统计学意义(P<0.05);研究组术后并发症发生率小于对照组,差异有统计学意义(P<0.05);研究组术后第1d、第3d、第5d的伤口疼痛程度明显小于对照组,差异有统计学意义(P<0.05);结论新辅助化疗下腹腔镜直肠癌根治术较传统开腹手术,临床疗效显著,是一种值得推广的治疗方法。
Objective To observe the clinical efficacy of laparoscopic resection of rectal cancer and conventional open surgery for rectal cancer under neoadjuvant chemotherapy. Methods One hundred and twenty patients with rectal cancer were random Ly divided into two groups. Neoadjuvant chemotherapy was performed. The study group underwent laparoscopic radical resection of the rectal cancer and the control group underwent open surgery. The basic conditions of surgery were compared between the two groups; postoperative complications were compared between the two groups; the degree of postoperative wound pain was compared between the two groups. Results There was no significant difference in the distance between the distal margin of the two groups and the number of lymph node dissections(P>0.05). The operative time, intraoperative blood loss, postoperative time of first discharge, length of hospital stay, total incision The length was less than the control group, and the difference was statistically significant(P<0.05). The incidence of postoperative complications was lower in the study group than in the control group(P<0.05); the first and third days of the study group were postoperative The degree of wound pain on the fifth day was significantly smaller than that of the control group(P<0.05). Conclusion The laparoscopic radical resection of rectal cancer under neoadjuvant chemotherapy is more effective than traditional laparotomy, and it is worthy of clinical application.
Objective To observe the clinical efficacy of laparoscopic resection of rectal cancer and conventional open surgery for rectal cancer under neoadjuvant chemotherapy. Methods One hundred and twenty patients with rectal cancer were random Ly divided into two groups. Neoadjuvant chemotherapy was performed. The study group underwent laparoscopic radical resection of the rectal cancer and the control group underwent open surgery. The basic conditions of surgery were compared between the two groups; postoperative complications were compared between the two groups; the degree of postoperative wound pain was compared between the two groups. Results There was no significant difference in the distance between the distal margin of the two groups and the number of lymph node dissections(P>0.05). The operative time, intraoperative blood loss, postoperative time of first discharge, length of hospital stay, total incision The length was less than the control group, and the difference was statistically significant(P<0.05). The incidence of postoperative complications was lower in the study group than in the control group(P<0.05); the first and third days of the study group were postoperative The degree of wound pain on the fifth day was significantly smaller than that of the control group(P<0.05). Conclusion The laparoscopic radical resection of rectal cancer under neoadjuvant chemotherapy is more effective than traditional laparotomy, and it is worthy of clinical application.
引文
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[5]李奎,曾玉剑,孙亮,等.腹腔镜与传统开放术式在低位直肠癌根治术中的比较研究[J].肿瘤学杂志,2015,21(1):21-25.
[6]陈策,王荣寅,丁德胜.对比常规开腹手术和腹腔镜下直肠癌手术的近期疗效及安全性分析[J].中华全科医学,2017,15(9):1515-1517.
[7]宋向东,刘争,李长春.开腹与腹腔镜直肠癌Dixon根治术效果比较[J].河南外科学杂志,2017,2(5):88-89.
[8]李西强,腹腔镜直肠癌Dixon根治术效果观察[J].河南外科学杂志,2016,22(2):30-31.
[9]吴凯,喻春钊.低位直肠癌及其腹腔镜手术特殊性与预防性造口的选择[J].中国微创外科杂志,2017,17(9):832-835.
[2]昝莉.直肠癌新辅助化疗的临床意义研究[J].临床合理用药,2017,10(4):11-12.
[3]Bonjer HJ,Deijen CL,Abis CA,et,al.A randomized trial of laparoscopic versus open surgery for rectal cancer[J].Nenjl J Med,2015,372(14):1324-1332.
[4]杜小凤,杨文奇,李霆.腹腔镜与开腹直肠癌根治术围手术期并发症及预后比较[J].安徽医学,2015,36(6):660-662.
[5]李奎,曾玉剑,孙亮,等.腹腔镜与传统开放术式在低位直肠癌根治术中的比较研究[J].肿瘤学杂志,2015,21(1):21-25.
[6]陈策,王荣寅,丁德胜.对比常规开腹手术和腹腔镜下直肠癌手术的近期疗效及安全性分析[J].中华全科医学,2017,15(9):1515-1517.
[7]宋向东,刘争,李长春.开腹与腹腔镜直肠癌Dixon根治术效果比较[J].河南外科学杂志,2017,2(5):88-89.
[8]李西强,腹腔镜直肠癌Dixon根治术效果观察[J].河南外科学杂志,2016,22(2):30-31.
[9]吴凯,喻春钊.低位直肠癌及其腹腔镜手术特殊性与预防性造口的选择[J].中国微创外科杂志,2017,17(9):832-835.