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目的探讨低位直肠癌腹腔镜规范化治疗效果。方法回顾性分析2013年6月到2015年9月行手术治疗的低位直肠癌患者134例,根据手术方式将患者分为腹腔镜组(75例)和开腹组(59例),用SPSS 16.0统计软件进行数据分析,术中术后恢复指标用(±s)表示,两组间差异比较采用t检验;并发症发生率和术后随访结果以(%)表示,卡方检验用于两组间差异比较;P<0.05有统计学差异意义。结果腹腔镜组的术中出血量、切口长度均低于开腹组(P<0.05);腹腔镜组的手术时间、手术切缘距齿状线距离高于开腹组(P<0.05);腹腔镜组术后肛门排气时间、术后进流食时间、术后自主下床时间、住院时间均低于开腹组,且差异均有统计学意义(P<0.05)。腹腔镜组术后并发症发生率5.3%(4例)显著低于开腹组16.9%(10例),且差异具有统计学意义(χ2=4.762,P<0.05);腹腔镜组术后随访3年无瘤生存率(71例,93.3%)高于开腹组(49例,81.3%),且差异具有统计学意义(χ2=4.505,P<0.05)。结论腹腔镜下低位直肠癌根治术的近期和远期疗效均好于开腹手术。
Objective To investigate the effect of laparoscopic standardized treatment of low rectal cancer. Methods A retrospective analysis of 134 patients with low rectal cancer undergoing surgical treatment between June 2013 and September 2015 was performed. According to the surgical methods, the patients were divided into laparoscopic group (n = 75) and open group (n = 59) Statistical software for data analysis, intraoperative postoperative recovery indicators ( ± s) that the difference between the two groups using t test; complication rate and postoperative follow-up results (%) said that the chi-square test for two Differences between groups; P <0.05 statistically significant difference. Results The intraoperative blood loss and incision length in laparoscopic group were significantly lower than those in laparotomy group (P <0.05). The laparoscopic operation time and the distance from the dentate line were higher than those in laparotomy group (P <0.05). The time of laparoscopic anus exhaust, the time of feeding after surgery, the time of going out of bed after surgery and the length of hospital stay were all lower than those of laparotomy group (P <0.05). The incidence of postoperative complications in laparoscopic group was significantly lower than that in open group (5.3%, 4 cases), significantly lower than that in open group (10 cases), and the difference was statistically significant (χ2 = 4.762, P <0.05) The 3-year disease-free survival rate (71 cases, 93.3%) was significantly higher than that in the open group (49 cases, 81.3%). The difference was statistically significant (χ2 = 4.505, P <0.05). Conclusions Short-term and long-term efficacy of laparoscopic radical rectal cancer is better than laparotomy.