目的

比较腹腔镜与开腹直肠癌切除术治疗中低位直肠癌的疗效及并发症情况。

方法

回顾性分析2019年1月至2023年1月收治的482例中低位直肠癌患者的病例资料，根据不同术式分为A组（n=245例，行腹腔镜直肠癌切除手术）和B组（n=237例，行开腹直肠癌切除手术）。采用SPSS 24.0分析数据。正态计量资料以（± s）表示，组间比较行独立样本t检验；计数资料以［例（%）］表示，行χ²检验；等级资料行秩和检验。P＜0.05示数据对比有统计学差异。

结果

A组患者手术时间长于B组，而术中出血量、术后初次通气时间以及住院时间均少于B组（P＜0.05）；两组患者的淋巴结清扫数目、环周切缘阳性例数、术后临床分期比较差异均无统计学意义（P＞0.05）；A组患者术后并发症总发生率为6.5%，低于B组的12.2%（P＜0.05）；A组患者术后1年内局部复发率和生存率分别为12.7%和97.6%，B组患者分别为13.1%和97.8%，差异无统计学意义（P＞0.05）。

结论

腹腔镜与开腹直肠癌切除手术治疗中低位直肠癌的肿瘤学效果及远期疗效相近，而相较于开腹手术，腹腔镜手术具有创伤小、术后恢复快、安全性高等优势。

Objective

To compare the efficacy and complications of laparoscopic and open rectal resection for middle and low rectal cancer.

Methods

Data of 482 patients with low and middle rectal cancer admitted from January 2019 to January 2023 were retrospectively analyzed and divided into group A (n=245 patients undergoing laparoscopic rectal cancer resection) and group B (n=237 patients undergoing open rectal cancer resection) according to different operation methods.SPSS 24.0 was used to analyze the data.Normal measurement data were expressed as(x±s), and independent sample t test was performed for comparison between groups.The counting data［ e.g.(%)］ were indicated by χ² test.Rank data row Rank Sum test.P＜0.05 indicates statistical difference in data comparison.

Results

The operative time of group A was longer than that of group B, but the intraoperative blood loss, the first postoperative ventilation time and the length of hospital stay were lower than those of group B (P＜0.05).There was no significant difference in the number of lymph node dissection, the number of positive circumferential margin and postoperative clinical stage between the two groups (P＞0.05).The total incidence of postoperative complications in group A was 6.5%, lower than 12.2% in group B (P＜0.05).The local recurrence rate and survival rate were 12.7% and 97.6% in group A and 13.1%and 97.8% in group B, respectively, with no statistical significance (P＞0.05).

Conclusion

Laparoscopic and open rectal cancer resection have similar oncology effects and long-term curative effects in the treatment of middle and low rectal cancer.Compared with open surgery, laparoscopic surgery has the advantages of less trauma, faster postoperative recovery and higher safety.