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目的探讨腹腔镜与开腹全直肠系膜切除术(TME)治疗中低位直肠癌患者的临床疗效。方法选取2010年3月至2014年4月医院治疗的86例中低位直肠癌患者为研究对象,按照随机、对照、平行设计原则分为两组,观察组43例患者行腹腔镜TME治疗;对照组43例患者行开腹TME治疗。比较两组患者手术时间等观察指标、预后情况以及术后并发症。结果观察组患者术中出血量为(85±18)ml、肛门排气时间为(2.2±0.4)d、切口愈合时间为(8.5±1.6)d、住院时间为(10.0±2.7)d、术后并发症发生率为20.9%,均少于对照组,差异均有统计学意义(均P<0.05);观察组患者淋巴结清扫数目为(13.2±2.9)枚、远处转移率为14.0%、局部复发率为4.7%、3年生存率为90.7%,与对照组比较,差异均无统计学意义(均P>0.05)。结论腹腔镜TME治疗中低位直肠癌临床疗效显著,可减少术中出血,加快患者康复速度,取得良好的预后,降低术后并发症发生率。
Objective To investigate the clinical effect of laparoscopic and open total mesorectal excision (TME) in the treatment of low and middle rectal cancer. Methods From March 2010 to April 2014, 86 patients with low and middle rectal cancer treated in our hospital were enrolled in this study. They were divided into two groups according to the randomized, controlled and parallel design principles. 43 patients in the observation group underwent laparoscopic TME. Group 43 patients underwent laparotomy TME treatment. The operation time and other indicators, prognosis and postoperative complications were compared between the two groups. Results The bleeding volume in the observation group was (85 ± 18) ml, the time of anal exhaust was (2.2 ± 0.4) days, the incision healing time was (8.5 ± 1.6) days and the hospitalization time was (10.0 ± 2.7) days The incidence of postoperative complication was 20.9%, both of which were less than those of the control group (all P <0.05). The number of lymph node dissection in the observation group was (13.2 ± 2.9) pieces and the distant metastasis rate was 14.0% The local recurrence rate was 4.7% and the 3-year survival rate was 90.7%. There was no significant difference between the two groups (all P> 0.05). Conclusions Laparoscopic TME has a significant clinical effect in treating low and middle rectal cancer, which can reduce the intraoperative bleeding, speed up the rehabilitation of patients, achieve a good prognosis and reduce the incidence of postoperative complications.