探讨单孔腹腔镜、多孔腹腔镜及开腹手术治疗直肠癌的临床效果。

回顾性分析2010年1月到2016年9月间手术治疗的70例直肠癌患者临床资料，行单孔腹腔镜切除术25例、多孔腹腔镜直肠癌切除术21例、开腹切除术24例。采用SPSS19.0软件包对数据进行统计描述和分析。术中、术后各项指标计量资料采用均数±标准差描述，组间比较采用单因素方差分析。术后并发症情况采用例数(百分比)描述，组间比较采用Pearson χ²检验。P<0.05为差异有统计学意义。

开腹组的手术时间显著少于单孔组和多孔组；开腹组的术中出血量显著多于单孔组和多孔组；单孔组的切口长度显著优于多孔组和开腹组(P<0.05)；开腹组的恢复饮食时间、引流管拔出时间、术后住院时间显著超过单孔组和多孔组，开腹组的住院总费用显著少于单孔组和多孔组(P<0.05)；单孔组、多孔组和开腹组在切除肿瘤体积、清扫淋巴结个数、清扫阳性淋巴结个数和术后并发症等比较差异无统计学意义(P>0.05)。

单孔、多孔腹腔镜手术治疗直肠癌的效果无明显差异，但单孔腹腔镜手术切口更小、美容效果好；腹腔镜手术对患者的创伤小、术后恢复快；开腹手术的手术时间短、住院总费用低。

To investigate the clinical outcome of single-port, multi-ports laparoscopic surgery and open surgery for rectal cancer.

The clinical data of 70 patients with rectal cancer, who receive surgical treatment, were analyzed retrospectively, including 25 cases of single-port, 21 cases of multi-ports laparoscopic surgery and 24 cases of open surgery. Clinical data were analyzed by using statistical software SPSS 19.0. Measurement data such as perioperative indicators were expressed as mean±standard deviation (±s), and one-way ANOVA was used for comparison between the groups. Count data, such as postoperative complication rate, were expressed as %, and were examined by using Pearson χ² test. A P value<0.05 was considered as statistically significant difference.

The operation time in open surgery group was significantly less than those either in the single-port or multi-ports laparoscopy group, hower with more blood loss Incision length of single-port group was significantly better than those either in multi-ports laparoscopy group or open surgery group (P<0.05). There was no significant difference of the tumor size, harvested lymph nodes, the number of positive harvested lymph nodes and postoperative complications between three groups (P>0.05).

There were no significant difference between single-port and multi-ports laparoscopic surgery in the treatment of rectal cancer, however single-incision laparoscopic surgery has smaller incision and better cosmetic effect. Laparoscopic surgery has advantages such as less trauma and faster postoperative recovery, and shorter operation time and lower total hospitalization cost.