宋永安

[摘要] 目的 比較腹腔镜与开腹结直肠癌根治术对患者胃肠功能的影响。 方法 将2014年1月～2017年1月我院接诊的62例结直肠癌根治术患者纳入本研究。按照随机数字表法将其均分为观察组和对照组各31例，对照组患者行开腹结直肠癌根治术，观察组患者行腹腔镜结直肠癌根治术，比较两组患者手术时间、术中出血量、标本切除长度、淋巴结清扫数、术后腹胀持续时间、术后肛门排气时间、术后住院时间、术后3年、5年无瘤生存情况。 结果 观察组患者手术时间显著长于对照组，术中出血量显著少于对照组，差异有统计学意义（P<0.05）；两组患者标本切除长度及淋巴结清扫数比较，差异无统计学意义（P>0.05）；观察组术后腹胀持续时间、术后肛门排气时间、术后住院时间均显著低于对照组，差异有统计学意义（P<0.05）；两组术后3年无瘤生存率及术后5年无瘤生存率比较，差异无统计学意义（P>0.05）。 结论 腹腔镜结直肠癌根治术效果与开腹手术一致，但创伤更小，术后胃肠功能恢复更快，可作为优选术式。

[关键词] 腹腔镜；开腹；结直肠癌根治术；胃肠功能

[中图分类号] R735.34 [文献标识码] B [文章编号] 1673-9701（2018）25-0048-03

[Abstract] Objective To compare the effects of laparoscopic and open radical resection on gastrointestinal function in patients with colorectal cancer. Methods 62 patients with colorectal cancer admitted to our hospital from January 2014 to January 2017 were included in this study. The patients were divided into the observation group and the control group，31 cases were divided into the observation group and the control group. The patients in the control group were treated with radical resection of colorectal cancer. The patients in the observation group were treated with laparoscopic radical resection for colorectal cancer. The operation time，the amount of bleeding， the length of the resection，the clearance of lymph nodes，the duration of postoperative abdominal distention， the postoperative abdominal distention， and the postoperative period were compared between the two groups. Anal exhaust time，postoperative hospitalization time，3 years and 5 years after surgery，tumor free survival. Results The operative time of the patients in the observation group was significantly longer than that in the control group. The amount of bleeding during the operation was significantly less than that of the control group（P<0.05），and there was no statistical difference between the two groups（P>0.05）. The duration of abdominal distention， the time of postoperative anus exhaust，and the postoperative hospital stay were significantly lower than those in the observation group. There was no significant difference in the disease-free survival rate and the 5 year disease-free survival rate between the two groups after 3 years（P>0.05）. Conclusion Laparoscopic radical resection of colorectal cancer is consistent with laparotomy，but with less trauma and faster recovery of gastrointestinal function after operation，it can be used as a preferred surgical procedure.

[Key words] Laparoscopy； Laparotomy； Radical resection of colorectal cancer； Gastrointestinal function

结直肠癌是我国发病率位居前列的恶性肿瘤，早期实施根治性手术切除是治疗该病的主要手段。直肠系膜切除术是结直肠癌治疗的金标准，但由于开腹手术创伤较大、并发症较多[1]。随着腹腔镜技术的不断发展，腹腔镜下结直肠癌根治术在结直肠癌治疗中逐渐显示出微创、准确度高、并发症少等优点[2]。大量国内文献报道[3]也证实了腹腔镜下结直肠癌根治术的疗效和安全性。但两种术式对患者胃肠功能的具体影响研究较少，本研究即针对腹腔镜与开腹结直肠癌根治术对患者胃肠功能的影响进行深入分析，以期为相关研究提供参考，现报道如下。……