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目的对比分析腹腔镜下直肠癌根治术与传统开腹手术患者术后近期获益情况,探讨腹腔镜下行直肠癌根治术的优势。方法收集2013年10月—2015年2月西安交通大学医学院第一附属医院肿瘤外科及普外科住院100例直肠癌患者的临床资料,随机划分为腹腔镜组64例和开腹组36例。通过观察二组患者术后近期恢复指标、术后并发症发生率,评价腹腔镜下行直肠癌根治术对患者近期获益程度。结果腹腔镜组术后各项恢复指标明显优于传统开腹组,而且腔镜手术安全性高,与术后发生吻合口瘘、术后腹腔感染率、心脑血管并发症、后伤口感染、脂肪液化、切口疝例数、吻合口狭窄、下肢静脉血栓形成、直肠阴道瘘、术后发生肠梗阻等并发症明显少于传统开腹组。腹腔镜组患者治疗前后KPS评分增加KPS≥20分及评分增加KPS≥10分例数明显高于传统开腹组。结论腹腔镜下行直肠癌根治术具有微创、患者术后恢复快、近期获益率高的优势,值得临床推广应用。
Objective To comparatively analyze the short-term benefit of laparoscopic radical resection of rectal cancer and traditional open surgery and to explore the advantages of laparoscopic radical rectal cancer radical surgery. Methods The clinical data of 100 patients with rectal cancer admitted to the First Affiliated Hospital of Xi’an Jiaotong University School of Medicine from October 2013 to February 2015 were randomly divided into laparoscopic group (64 cases) and open group (36 cases). By observing the recent postoperative recovery index and the incidence of postoperative complications in the two groups of patients, we evaluated the patients’ immediate benefit on laparoscopic radical rectal cancer. Results All indexes of recovery after laparoscopic surgery were significantly better than those of conventional laparotomy. The laparoscopic surgery was safe, with anastomotic fistula, postoperative abdominal infection rate, cardiovascular and cerebrovascular complications, post wound infection, Fat liquefaction, number of incisional hernia, anastomotic stenosis, lower extremity venous thrombosis, rectovaginal fistula, postoperative intestinal obstruction and other complications were significantly less than the traditional open group. Before and after treatment in patients with laparoscopic KPS score increased KPS ≥ 20 points and score increased KPS ≥ 10 cases were significantly higher than the traditional open group. Conclusions Laparoscopic radical rectal cancer with minimally invasive radical surgery, patients recover quickly, the recent high rate of benefit, it is worth promoting the clinical application.