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目的:探讨三孔法腹腔镜直肠癌根治术的可行性及近期临床效果,对三孔法腹腔镜直肠癌根治术的临床应用价值进行前瞻性研究分析。方法:根据严格的入组标准将2004年6月至2009年12月在我科收治的符合入组条件的直肠癌病人700例分成三孔法腹腔镜组(n=345)和传统开腹手术组(n=355)。比较两组病人的术中及术后一般情况、手术相关病理学因素、术后并发症及1～5年随访资料等。结果:对比开腹手术组,三孔法腹腔镜组病人术中出血量少;术后下床时间早,排气快,但平均手术时间更长。在并发症发生率、切除标本中淋巴结个数、下切缘距肿瘤距离及随访效果方面两组无统计学差异。结论:三孔法腹腔镜直肠癌根治术对腹腔镜技术要求较高,但安全可行,具有传统开腹手术相同的根治效果及更好的近期疗效。
Objective: To investigate the feasibility and short-term clinical efficacy of three-hole laparoscopic radical resection of rectal cancer and prospectively analyze the clinical value of three-hole laparoscopic radical resection of rectal cancer. Methods: According to the strict inclusion criteria, 700 eligible patients with rectal cancer admitted to our department from June 2004 to December 2009 were divided into three-hole laparoscopic group (n = 345) and conventional laparotomy Group (n = 355). The two groups of patients were compared intraoperative and postoperative general conditions, surgical pathological factors, postoperative complications and 1-5 years follow-up data. Results: Compared with the laparotomy group, the three-hole laparoscopic group had less intraoperative blood loss, earlier bed-out time and faster extubation, but the average operation time was longer. There was no significant difference between the two groups in the incidence of complications, the number of lymph nodes in the resected specimens, the distance between the lower incision and the tumor and the follow-up effect. Conclusions: The three-hole laparoscopic radical mastectomy for laparoscopic rectal cancer requires higher laparoscopic technique, but is safe and feasible. It has the same radical curative effect and better short-term curative effect.