腹腔镜直肠癌根治术与开腹手术的临床对比分析

发布时间：2018-01-28 23:19

本文关键词： 腹腔镜直肠癌传统开腹病例对照研究　出处：《昆明医科大学》2015年硕士论文　论文类型：学位论文

【摘要】：[目的]评价腹腔镜直肠癌根治术的临床应用价值,疗效及对患者术后生活质量的影响。[方法]回顾分析昆明医科大学第二附属医院胃肠外科自2009年1月至2013年1月手术病人中81例直肠癌患者的临床资料,其中41例行腹腔镜直肠癌根治术(28例行Dixon手术,13例行Miles手术),40例行开腹直肠癌根治术(Dixon手术27例、Miles手术13例),对比分析两组患者患者的淋巴结清除数,术后并发症、手术时间、直肠全系膜切除情况、出血量、胃肠功能恢复时间、下床活动时间、排尿功能恢复情况、住院时间及术后随访结果。[结果]81例直肠癌根治术均获成功,腹腔镜组无一例中转开腹,腹腔镜组与开腹组一般资料差异无显著性。腹腔镜组与开腹组的平均手术时间分别为212.35min和160.23 min,有显著差异(P0.01),但随着例数的增加腹腔镜手术的时间呈明显下降趋势,后15例病人的平均手术时间为176.52 min,与开腹组比较无显著差异(P0.05)。术中出血量、直肠系膜切除质量腹腔镜组显著优于开腹组,腹腔镜组住院时间明显短于开腹组,腹腔镜组术后下床活动时间、胃肠功能恢复及排尿功能恢复时间明显早于开腹组,保肛率、淋巴结清除数量、术后两年生存率两组差异无统计学意义。[结论]腹腔镜直肠癌根治术微创、安全、有效,并且视野清晰,解剖层次清楚,操作方便,患者恢复快。
[Abstract]:[Objective] to evaluate the clinical value, curative effect and quality of life of laparoscopic radical resection of rectal cancer. [Methods the clinical data of 81 patients with rectal cancer in the second affiliated Hospital of Kunming Medical University from January 2009 to January 2013 were analyzed retrospectively. Among them 41 cases underwent laparoscopic radical resection of rectal cancer 28 cases underwent Dixon operation 13 cases underwent Miles operation and 40 cases underwent radical resection of rectal cancer. The number of lymph node clearance, postoperative complications, operative time, total mesorectal excision, bleeding volume and recovery time of gastrointestinal function were compared and analyzed in 13 cases of Miles operation. The time of getting out of bed, the recovery of urination function, the time of hospitalization and the results of postoperative follow-up. [Results] all the 81 cases of rectal cancer were successfully operated, and none of the cases in the laparoscopic group was converted to open operation. There was no significant difference in general data between the laparoscopic group and the open group. The mean operative time of the laparoscopic group and the open group were 212.35 and 160.23 min, respectively. There was a significant difference (P 0.01), but with the increase of the number of cases, the time of laparoscopic surgery decreased significantly. The average operative time of the latter 15 patients was 176.52 min. There was no significant difference between the laparoscopy group and the open group (P 0.05). The amount of blood lost during the operation, the quality of mesorectal excision in the laparoscopic group was significantly better than that in the open group, and the hospital stay in the laparoscopic group was significantly shorter than that in the open group. There was no significant difference between the laparoscopy group and the laparotomy group in the time of getting out of bed, the recovery of gastrointestinal function and urination function, the anus preserving rate, the number of lymph node clearance, and the two year survival rate of the two groups. [Conclusion Laparoscopic radical resection of rectal cancer is minimally invasive, safe, effective, with clear visual field, clear anatomical level, convenient operation and quick recovery.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R735.37

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