| Objectives:Operation is the method that can treat colorectal cancer radically. With the development of minimal invasive technique, laparoscopic assisted colorectal cancer radical resection has been proven to have equivalent curative effect with open radical resection. But due to the particularity and complexity of rectal cancer lesion location, the curative effect of laparoscopic assisted colorectal cancer radical resection remains controversial. By comparing the clinical curative effects of laparoscopic assisted colorectal cancer radical resection and open colorectal cancer radical resection, this study shall provide references for choosing clinical operation ways of rectal cancer.Materials and methods:In accordance with the inclusion criteria and exclusion criteria, the clinical data of 380 patients with rectal cancer that had received operation from September 2009-January 2015 in gastrointestinal surgery department of Subei People Hospital were selected, and there were 190 cases of laparoscopic assisted rectal cancer radical resection (laparoscopic group), including 102 cases of laparoscopic rectal low anterior resection (Dixon operation) operation and 88 cases of laparoscopic abdominoperineal resection (Miles operation). There 190 cases of open rectal cancer radical resection, including 107 cases of rectal low anterior resection (Dixon) and 83 cases of laparoscopic abdominoperineal resection (Miles). There was no evident difference in the general data of two groups. A retrospective analysis was conducted on the clinical data of two groups and the intraoperative blood loss, operative length, lymph node dissection number, postoperative drainage volume, postoperative complications, postoperative discharge time, postoperative follow-up data of two groups were compared and analyzed. The advantages and disadvantages of laparoscopic assisted rectal cancer radical resection and open rectal cancer radical resection were compared, so as to provide clinical evidence for choose operation ways of rectal cancer.Results:The surgeries of two groups were completed smoothly, without death cases during the operation. By comparing the clinical data of patients from two groups, there was no significant difference in age, gender, and distance from the tumor to anus (P> 0.05). The laparoscopic group: the intra-operative blood loss 111.55±97.39ml, intra-operative lymph node dissection number 9.41±5.44, including 0.95±2.17 positive lymph nodes, operation length 167.32±42.71 minutes, total postoperative drainage volume 331.33±231.57ml, postoperative complications occurred to 35 cases, including 13 cases of incision infection,2 cases of dysuria,4 cases of ureteral injury,9 case of anastomotic fistula,7 cases of other complications, with the occurrence rate of complication 18.42%, the postoperative discharge time 11.83±3.91 days,36 death cases, with the death rate of 18.95%. The open group:the intra-operative blood loss 138.55±86.35ml, intra-operative lymph node dissection number 8.03±4.94, including 0.80±2.00 positive lymph nodes, operation length 142.61±45.95 minutes, total postoperative drainage volume 327.05±234.32ml, postoperative complications occurred to 52 cases, including 25 cases of incision infection,4 cases of dysuria,2 cases of ureteral injury,13 cases of anastomotic fistula,8 cases of other complications, with the occurrence rate of complication 27.37%, the postoperative discharge time 13.33±6.04 days,43 death cases, with the death rate of 22.63%.Patients from two groups had significant difference in intraoperative blood loss, lymph node dissection number, occurrence rate of postoperative complications, postoperative discharge time, operative length (P<0.05). The laparoscopic assisted rectal cancer radical resection had less intraoperative blood loss, more intraoperative lymph node dissection number, less postoperative complications, shorter postoperative hospital stay, etc., while the open group had shorter operation length. They had no statistical significance in the positive lymph node dissection number, post-operative 3 day drainage volume and total survival rate after operation (P>0.05).Conclusion:1. Compared with open rectal cancer radical resection, laparoscopic assisted cancer radical radical resection has advantages of less intraoperative blood loss, more intraoperative lymph node dissection number, less postoperative complications, shorter postoperative hospital stay, etc., but the operation time will be extended.2. The disease free survival rate, metastasis, recurrence rate and death rate of laparoscopic assisted radical resection are similar to that of open radical resection. |
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