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目的:比较完全腹腔镜与腹腔镜辅助直肠癌低位吻合保肛手术的近期疗效。方法:对照研究2004年3月至2007年3月广西壮族自治区人民医院施行的完全腹腔镜直肠癌低位吻合保肛术21例及同期腹腔镜辅助直肠癌低位吻合保肛术23例,将其临床资料进行比较分析。结果:完全腹腔镜组手术时间、术中失血量、术后48h引流量与腹腔镜辅助组比较,无统计学意义(P>0.05)。肛门排气时间及开始进食时间,完全腹腔镜组与腹腔镜辅助组比较有统计学意义,前者肠道功能恢复较早(P<0.05)。术后住院时间完全腹腔镜组比腹腔镜辅助组缩短(P<0.05)。完全腹腔镜组与腹腔镜辅助组远切缘距癌肿病灶边缘距离、清扫淋巴结数目,两组均无显著性差异(P>0.05)。完全腹腔镜组与腹腔镜辅助组比较,手术耗材费减少(P<0.05)。结论:完全腹腔镜可达到腹腔镜辅助直肠癌低位吻合保肛手术同样的肿瘤根治效果,且完全腹腔镜组具有美观、肠道恢复快、住院时间短、费用经济的优点。
OBJECTIVE: To compare the short-term effect of anastomosis with complete laparoscopy and laparoscopic assisted rectal cancer. Methods: From March 2004 to March 2007, 21 cases of complete anastomosis of low anastomosis of laparoscopic rectal cancer performed by People’s Hospital of Guangxi Zhuang Autonomous Region from March 2004 to March 2007 and 23 cases of low anastomosis and anus preservation assisted by laparoscopic assisted rectal cancer were included in the study. Data for comparative analysis. Results: There was no significant difference between laparoscopic group and laparoscopic group in operation time, intraoperative blood loss and drainage volume at 48 hours after operation (P> 0.05). Anal exhaust time and beginning of eating time, complete laparoscopic group and laparoscopic auxiliary group was statistically significant, the former intestinal function recovered earlier (P <0.05). The length of postoperative hospital stay was shorter in laparoscopic group than in laparoscopic group (P <0.05). There was no significant difference between the two groups (P> 0.05). There was no significant difference between the complete laparoscopic group and the laparoscopic auxiliary group in the margins of the margins of cancer lesions and the number of lymphaden nodes. Compared with the laparoscopic group, the total cost of surgical laparoscopy was lower (P <0.05). Conclusions: Complete laparoscopy can achieve the same tumor curative effect of laparoscopic assisted anastomosis and anal sphincter preservation. The complete laparoscopic group has the advantages of good appearance, fast intestinal recovery, short hospital stay and economical cost.