目的探讨腹腔镜与开腹直肠癌根治术的远期和近期临床疗效的比较。方法对2009年1月至2011年12月我院完成的开腹直肠癌根治术38例及腹腔镜直肠癌根治术24例进行系统性回顾分析，比较两组手术安全性、术后并发症、生存率及远期癌症复发转移情况。结果腹腔镜组手术平均时间与开腹组相比差异无统计学意义[（201±52）min比（198±41）min， P＞0.05]。腹腔镜组术中出血量、切口长度显著低于开腹手术组。腹腔镜组肿瘤近、远端切缘长度分别为（6.2±1.9）cm、（5.7±1.7）cm，开腹组肿瘤近、远端切缘长度分别为（6.4±2.0）cm、（5.9±1.7）cm，P＞0.05两组相比差异无统计学意义。胸腔镜组与开腹组出血量分别为（65±13）mL和（171±19）mL，P＜0.05两组相比差异有统计学意义。胸腔镜组与开腹组淋巴结清扫数量分别为（11.0±2.7）枚和（12.0±3.6）枚，P＞0.05，两组相比差异无统计学意义。结论腹腔镜与开腹直肠癌根治术在生存率及术后复发方面无显著性差异，且具有创伤小、术后恢复快、并发症少等优点。%Objective To evaluate the results of laparoscopic and open radical operation for rectal cancer. Methods We retrospectively analyzed the clinical and follow-up data of 38 cases with open operation during the period of January 2009 to December 2011,compared with 24 cases with laparoscopic operation at the same time at our hospital. The surgical safety, postoperative complications,survival rate, and the recurrence and metastasis of cancer were compared. Results there was on signiifcal difference at the average time of laparoscopic and open radical operation procedures (201±52)min vs.(198±41)min, but blood loss during operation and length of incision in laparoscopic group were signiifcant less than the open radical operation group. The proximal and distal length were, respectively,(6.2±1.9)cm and(5.6±1.8)cm in laparoscopic group and (6.4±2.0)cm and(5.9±1.7)cm in the open radical operation group, the difference was not signiifcant. The intraoperative blood loss in laparoscopic group was obviously less than in open group (65±13)mL and (171±19)mL.The number of lymph node dissections was also similar:(11.0 ±2.7) in laparoscopic group and (12.0±3.6) in the open radical operation group. Conclusion Laparoscopic surgery for cancer achieve similar long-term survival as conventional laparotomy with minimal invasion,quicker recovery and less complications.
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