| laparoscopic operation has been widely used in the clinic ,especiallyin the cholecystectomy taking advantage of its merits, such as minimalinvasion,less trauma, rapid recovery et al. Be of its good qualities, theminimally invasive surgery has been widely applied in appendectomy ,splenectomy , nephrectomy, hysterectomy and many other operations .Although tissue of rectal cancer also can be cut by this technique iniabstracto, controversy still remained so far, mainly about the effect of thismethod for the rectal carcinoma , i.e. thoroughness of radical correction,recurrence rate and survival rate. There was not any evidence to provethat the laparoscopic operations have super benefits compared withroutine operation , the effects of this method need more investigation ,Can laparoscopic operation comply with the "no tumor principle"?Whether it lead to the spread of cancer? In order to estimate the effectof radical resection of rectal carcinoma used laparoscopic operation , wecompared two nonrandom groups at the same time, one group is that thepatients underwent laparoscopic operation, and the other groupunderwent routine operation. Recovery after operation, pathologicdiagnosis of the specimens and clinical effects were compared.Objective:Application of laparoscopic operation as adjunctivetherapy in the radical resection of rectal carcinoma compared withtraditional operation.Cases and Methods:We divided the patients into two groupsaccording to the patient′will, they accepted laparoscopic operation andtraditional operation repectively.All the patients must be excludedanyone of the following case: palliative resection, emergency operationwith acute bowel obstruction or massive hemorrhage of gastrointestinaltract, abdominal operation before, combined operation of partialhepatectomy for liver metastasis. In all of case ,522 patients werereceived traditional operation strictly abide by "no tumor principle", 34cases were collected randomly . Specimens were sent to pathologicaldepartment after operations. The size, infiltration depth, margins, totaland positive lymph nodes of each specimen were recorded and werestaged according to Dukes. Patients were followed up according theiraddresses and telephone,Leters were adopted as a supplement. Themain content follow-up visit include metastasis of cut, local relapse ,distant metastasis et al.Results:10 cases and 34 cases was enrolled into laparoscopicgroup and transabdominal group respectively. There were no severeoperating complications and death related operation. There no obvioussignificant on the time of operation , operating complications betweenlaparoscopic group and transabdominal group(P>0.05). Bleeding duringthe operation(118±74)ml, the time of aerofluxus after operation(2.2±0.6)d ,the time of getting out of bed (3.9±1.6)dand length of stay(5.4±1.8)d were superior to the transabdominal group. The length of specimen(21.77±3.45)cm, cleaning lymph nodes besides intestine, mesenterium,vascular roots and total amount of the lymph nodes(10.8±1.6) of thelaparoscopic group had no significant compared with what (11.3±2.3)of the transabdominal group. There were no difference also in the cost ofhospitalization , short term survival rate, local relapse , distant metastasisbetween two groups.Conclusion : Application of laparoscopic operation as adjunctivetherapy in the radical resection of rectal carcinoma are minimallyinvasive ,effective, economic operation and applying with "no tumorprinciple. |
