中国实用外科杂志2016，Vol.36Issue(10)：1084-1089,6.DOI:10.7504/CJPS.ISSN1005-2208.2016.10.17
改良两孔法与常规五孔法腹腔镜直肠癌前切除术短期疗效比较
Clinical comparison of short-term treatment outcomes between two-port and conventional laparoscopic anterior resection for rectal cancer
摘要
Abstract
Objective To explore and analyze the safety and feasiblity of two-port laparoscopic anterior resection for rectal cancer. Methods The clinical data of 38 patients underwent two-port laparoscopic surgery and 40 patients underwent conventional laparoscopic surgery for treatment of rectal cancer in Shengjing Hospital, China Medical University between June 2012 and December 2014 were analyzed retrospectively. The blood loss, duration of procedure, intraoperative complication, conversion to open surgery, length of abdominal incision, distal resection margin, rates of circumferential resection margin involvement, number of lumph nodes havested, postoperative TNM stage, reoperation, duration before first flatus, postoperative complication, postoperative pain score, systemic stress responses and length of postoperative hospital stay of the two groups were analyzed. Results No significant difference was observed in blood loss, operative time, conversion rate, distal resection margin, rates of circumferential resection margin involvement, number of lumph nodes havested, postoperative TNM stage, duration before first flatus,intraoperative and postoperative complication, and length of postoperative hospital stay between the two groups(P>0.05). Two-port group had shorter length of abdominal incisions[(5.1 ± 0.5)cm vs.(8.4 ± 0.9)cm, P<0.05]. Postoperative pain scores were lower in the two-port group at 24h[(4.1±1.3)vs.(5.0±1.6), P<0.05], 48h[(2.8±1.1)vs. (4.0±1.4), P<0.05] and 72h[(1.9 ± 1.1)vs.(2.7 ± 1.2), P<0.05]. The level of C-reactive protein[13.2(1.3~111.7)mg/L vs. 22.2(6.9~135.0)mg/L, P<0.05],interleukin-6[(20.8 ± 9.4)ng/L vs.(26.6 ± 13.6)ng/L, or 20.5(6.1~45.5) mg/L vs. 30.8(6.3~60.2) mg/L, P<0.05], and cortisol[(619.4 ± 185.4)nmol/L vs.(754.6 ± 164.1)nmol/L,or 499.7(300.8~935.7) nmol/L vs. 777.2 (533.7~1008.5)nmol/L, P<0.05]in the two-port group were lower than those in conventional laparoscopic surgery group at 1 day postoperatively. The level of C-reactive protein[(30.1±27.4)mg/L vs.(64.1±49.1)mg/L,or 20.8(1.4~110.1) vs. 68.7(9.7~176.6)mg/L, P<0.05]and cortisol[566.7(438.6~1005.2)nmol/L vs.666.2(100.5~1099.8)nmol/L,P<0.05]in the two-port group was lower than that in conventional laparoscopic surgery group at 2 day postoperatively. The level of C-reactive protein[12.5(1.5~111.1)mg/L vs. 23.4(9.7~167.8)mg/L, P<0.05] was lower than that in conventional laparoscopic surgery group at 3 day postoperatively. Conclusion Two-port laparoscopic anterior resection for rectal cancer is safe and feasible. It is not worse than conventional laparoscopic surgery in terms of short-term perioperative and oncological outcomes and has the benefits of less postoperative pain and less systemic stress response.关键词
直肠肿瘤/腹腔镜/减孔手术/直肠前切除术Key words
rectal carcinoma/laparoscopy/reduced-port laparoscopic surgery/anterior resection for rectal cancer分类
医药卫生引用本文复制引用
张宏,凌云志,丛进春,崔明明,刘鼎盛,陈春生..改良两孔法与常规五孔法腹腔镜直肠癌前切除术短期疗效比较[J].中国实用外科杂志,2016,36(10):1084-1089,6.基金项目
辽宁省自然科学基金资助项目 （）
