作者：胡斌，陈声飞，邓剑，倪新建，阙剑锋，刘跃强，黄嘉俊，邓守庭

单位：广东博罗县人民医院 普通外科，广东 博罗 516100

Authors:  HU Bin, CHEN Shengfei, DENG Jian, NI Xinjian, QUE Jianfeng, LIU Yueqiang, HUANG Jiajun, DENG Shouting.

Unit:  Department of General Surgery, Boluo county People's Hospital, Boluo 516100, Guangdong, China

摘要：

目的  对比分析双视免气腹腔镜辅助下与开腹直肠癌根治术的疗效,探讨双视免气腹腔镜辅助下直肠癌根治术的安全性和有效性。方法  选择2008年6月至2015年6月我院应用双视免气腹腔镜手术设备辅助下行直肠癌根治术208例为观察组,纳入同期传统开腹行直肠癌根治术178例为对照组,比较两组切口长度、手术时间、术中出血量、肛门恢复排气时间、住院时间、切口感染率、早期肠梗阻发生率、淋巴结清扫数、吻合口漏发生率及直肠癌复发率。结果  和对照组比较,观察组切口长度更短(52.0 mm vs.129.6 mm)、术中出血量更少(81.0 ml vs.146.5 ml)、肛门恢复排气时间更早(59.5 h vs.83.6 h)、住院时间更短(11.天3 vs.15.6天)、切口感染率更低(0.96%vs.5.06%)、早期肠梗阻发生率少(0.48%vs.4.49%),组间差异均有统计学意义(P<0.05)。然而,观察组的淋巴结清扫数、吻合口漏发生率、术后肠癌复发率、手术时间等与对照组相比并无显著差异(P>0.05)。结论  应用双视腹腔镜设备辅助下行直肠癌根治术是安全有效的,并具有手术视野好、切口短、疼痛轻、术后恢复快等优点。

关键词： 双视免气腹腔镜; 开腹手术; 直肠癌; 疗效

Abstract：

Objective  To explore the clinical efficiency of double-view laparoscopic-assisted radical resection for rectal carcinoma (RC) versus laparotomy. Methods  From June 2008 to June 2015, 208 RC patients who had underwent double-view laparoscopic-assisted radical resection were assigned into observation group, whereas other 178 RC patients who had received traditional laparotomy were regarded as control group. We compared length of incision, time of operation, amount of bleeding, anus evacuation time, length of hospital stay, infection rate of incision, intestinal obstruction, lymph node dissection amount, anastomotic leak rate, tumor recurrence rate. Results  The length of incision in the observation group was much less than that in the control group (52.0 vs. 129.6 mm, P<0.05), as well as the amount of bleeding (81.0 vs. 146.5 ml), first flatus time (59.5 vs. 83.6 h), length of hospital stay (11.3 vs. 15.6 day), incidence of incisional infection (0.96% vs. 5.06%) and intestinal obstruction (0.48% vs. 4.49%). There was no significant difference in the lymph node dissection amount, anastomotic leak rate, tumor recurrence rate, time of operation between both groups (P>0.05). Conclusions  Double-view laparoscopic-assisted radical resection for rectal carcinoma is safe and feasible, which has superior advantages of good surgical view, short incision, light pain, quick postoperative recovery over conventional laparotomy.

Key Words:  Double-view laparoscope; Laparotomy; Rectal cancer; Efficacy