作者：张营，郑冬琴，李吴寒，王高生

单位：中国科学技术大学附属第一医院(安徽省立医院)南区 急诊外科，安徽合肥 230036

Authors:  Zhang Ying, Zheng Dongqin, Li Wuhan, Wang Gaosheng

Unit:  The First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital) South District, Hefei 230036, Anhui, China

摘要：

目的 探究3D和2D腹腔镜在直肠癌根治术的临床价值对比。方法 选取2016年5月至2018年5月我院就诊的114例直肠癌患者,采用随机数字表分组,分观察组和对照组,各57例,两组患者入组后完善术前准备,均行腹腔镜下直肠癌根治术,其中观察组患者采用3D腹腔镜下直肠癌根治术治疗,对照组患者采用2D腹腔镜下直肠癌根治术治疗,比较两组患者手术情况,包括手术时间、术中出血量、淋巴结清扫数目等;比较两组患者术后恢复情况及并发症发生情况;比较两组患者术后标本病理学指标;比较两组患者术后引流管留置时间。结论 观察组患者手术时间、术中出血量较对照组患者明显降低,结果具有统计学意义(P<0.05),两组患者淋巴结清扫数目无明显差异;观察组患者术后并发症发生率较对照组患者明显降低,结果具有统计学意义(P<0.05),两组患者胃肠功能恢复时间、住院时间、住院费用等差异无统计学意义(P>0.05);两组患者术后病理指标,包括肿瘤距切缘下距离与标本长度无明显差异(P>0.05);观察组患者引流管留置时间较对照组患者明显降低,差异具有统计学意义(P<0.05)。结论 3D腹腔镜下直肠癌根治术较传统2D腹腔镜下直肠癌根治术临床效果更好,并发症发生率更低,能有效缩短住院时间,对患者术后快速康复有一定积极。

关键词：  3D腹腔镜; 直肠癌根治术; 快速康复; 淋巴结清扫

Abstract：

Objective To explore the difference of clinical efficacy in rectal cancer between 3D and 2D laparoscopic radical resection. Method A total of 114 patients with rectal cancer treated in our hospital from May 2016 to May 2018 were selected and randomly divided into observation group and control group with 57 cases in each group. All patients underwent laparoscopic radical resection of rectal cancer. The patients in observation group were treated with 3D laparoscopic radical resection of rectal cancer, while those in control group were treated with 2D laparoscopic radical resection of rectal cancer. The operation time, intraoperative bleeding volume and number of lymph node dissection were compared between the two groups. The recovery and complications of the two groups were compared. The pathological indexes of the samples of the two groups were similar. The indwelling time of the drainage tube was compared between the two groups. Results Observing the operation time of the patients, the amount of bleeding during the operation was significantly lower than that of the control group (P< 0.05). There was no significant difference in the number of lymph nodes between the two groups (P>0.05). The incidence of complications in the observation group was significantly lower than that in the control group (P<0.05), there was no significant difference in the recovery time of gastrointestinal function, hospitalization time and hospitalization expenses between the two groups (P>0.05); there was no significant difference in the postoperative pathological parameters between the two groups, including the distance between the tumor and the incision margin and the standard length (P>0.05); it was observed that the indwelling time of the drainage tube in the two groups was significantly lower than that in the control group. Statistical significance (P<0.05). Conclusion 3D laparoscopic radical resection for rectal cancer has better clinical effect than traditional 2D laparoscopic radical resection for rectal cancer. The indwelling time of drainage tube is shorter, and the incidence of complications are lower and worthy of clinical promotion.

Key Words:  3D laparoscopy; Colorectal cancer; Indwelling time of drainage tube; Lymph node dissection