3D与2D腹腔镜直肠癌根治术的近期疗效分析

Study of short-term effects of 3D and 2D laparoscopic radical resection of rectal cancer

关键词:  直肠癌  根治术  腹腔镜  3D  2D

Key words:  rectal neoplasms  radical resection  laparoscopy  three-dimension  two-dimension

摘要:

目的　研究比较3D腹腔镜直肠癌根治术与2D腹腔镜直肠癌根治术的近期临床疗效。 方法　收集2014年1月至2017年8月大连医科大学附属第二医院胃肠外科收治的148例行腹腔镜直肠癌根治术患者的临床资料，对患者围手术期临床资料进行统计学分析。 结果　两组患者均顺利完成腹腔镜直肠癌根治术，无中转开腹，无围手术期死亡。3D组与2D组术中出血量分别为（74.42±36.87）mL和（102.76±67.31）mL，淋巴结清扫数目分别为（14.69±7.45）枚和（9.10±4.69）枚，术后首次排气时间分别为（2.22±1.16）d和（2.84±1.22）d，术后进流食时间分别为（2.56±1.94）d和（4.14±1.48）d，两组上述指标比较，差异均有统计学意义（P<0.05）。3D组与2D组手术时间分别为（152.19±31.11）min和（165.00±55.41）min，拔除引流管时间分别为（9.52±5.85）d和（9.23±4.10）d，术后住院时间分别为（12.09±7.20）d和（10.55±4.10）d，两组比较，差异均无统计学意义（P>0.05）。3D组与2D组术后并发症分别为11例和8例，两组比较，差异无统计学意义（P>0.05）。 结论　3D腹腔镜直肠癌根治术安全、可行；淋巴结清扫更彻底，手术创伤更小，利于患者术后快速康复。

Abstract:

Objective To compare the short-term effects of 3D and 2D laparoscopic radical resection of rectal cancer. Methods One hundred and forty-eight patients, who suffered from rectal cancer and underwent laparoscopic radical resection of rectal carcinoma in the Department of Gastrointestinal Surgery at Dalian Medical University Second Affiliated Hospital from Jan 2014 to Aug 2017, were included in the study. The clinical data of perioperative period were analyzed statistically. Results There was no statistically significant difference between the 2 groups in general clinical data. (P>0.05). All of the surgeries were performed successfully. There was neither conversion to open surgery nor perioperative death in the perioperative period in all 148 cases. The intraoperative blood loss, the number of harvested lymph node, the postoperative passage of flatus, and the time to initiate oral intake were (74.42±36.87)mL, (14.69±7.45), (2.22±1.16)days, (2.56±1.94)days in the 3D group and (102.76±67.31)mL, (9.10±4.69), (2.84±1.22)days, (4.14±1.48)days in the 2D group, respectively and exhibited statistically significant difference between the 2 groups (P<0.05). The operation time, the time for indwelling catheter, the length of postoperative hospital stay were (152.19±31.11)minutes, (9.52±5.85)days, (12.09±7.20)days in the 3D group and (165.00±55.41) minutes, (9.23±4.10)days, (10.55±4.10)days in the 2D group, respectively without statistically significant difference between the 2 groups (P>0.05). Postoperative complications were detected in 11 patients in the 3D group and 8 patients in the 2D group, with no statistically significant difference between the 2 groups (P>0.05). Conclusion Compared with 2D laparoscopy, 3D laparoscopic radical resection of rectal cancer is safer and more feasible. More importantly, 3D laparoscopic surgery is more efficient in short-term effects. 3D laparoscopic surgery for rectal cancer, compared with 2D laparoscopic technology has significant advantages, which can decrease intraoperative blood loss, facilitate recovery of postoperative gastrointestinal function, and dissect lymph node more thoroughly.