Clinical outcomes of laparoscopic total mesorectal excision compared to open surgery in patients with middle and low rectal cancers
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目的：比较腹腔镜与开腹全直肠系膜切除（T M E）手术治疗中低位直肠癌的临床疗效。方法：选取本院2009年1月至2013年12月接收的106例中低位直肠癌患者，随机分为腹腔镜组和开腹组，比较两组患者术中各项指标、肿瘤治疗情况、术后恢复情况及术后并发症等指标。结果：两组患者相比较，腹腔镜组手术用时相对长，术中失血量及保留肛门括约肌率要优于开腹组，两组间差异有统计学意义（P＜0.05）；术后镇痛时间、留置尿管时间、肛门排气时间及术后住院天数等指标，腹腔镜组均少于开腹组，两组间差异有统计学意义（P＜0.05）；肿瘤治疗情况：切除标本长度、淋巴结清除数和切缘阳性率等，两组间差异无统计学意义（P＞0.05）；术后并发症两组间差异无统计学意义（P＞0.05）。结论：腹腔镜T M E手术是安全、微创且有效的，具有与开腹手术相同的肿瘤治疗效果。
AIM: To investigate the clinical outcomes of laparoscopic total mesorectal excision compared to open surgery in patients with middle and low rectal cancers. METHODS:106 patients with middle and low rectal cancer were randomly assigned to either the laparoscopic TME group or the open TME group between January 2009 and December 2013 at our hospital. Clinical outcomes were compared in those two groups, such as operative information, post surgery recovery and oncological outcomes. RESULTS: Compared to open surgery, laparoscopic surgery have longer operating time, less blood lose and more sphincter-preserving. Concerning postoperative analgesia, duration of urinary drainage, time to pass flatus and postoperative hospital stay, laparoscopic surgery has more benefits. The complication rate, circumferential margin involvement, distal margins and lymph node yield were similar for both procedures. CONCLUSION: Laparoscopic TME is safe, minimal invasive and effective, with an oncological adequacy comparable to the open approach.
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