Clinical Comparative Study Of Laparoscopic Surgery And Traditional Open Surgery For Radical Resection Of Rectal Cancer

Objective:A retrospective clinical comparative study of laparoscopic surgery and traditional open surgery for anus preserved rectal cancer radical surgery(Dixon)further clarified the advantages and limitations of two surgical procedures for anus preserved rectal cancer radical resection.Furthermore,it is a reference for the selection of surgical methods for anus preserved radical rectal cancer radical resection in various situations.Methods:Retrospective analysis of clinical data from 58 patients who underwent laparoscopic surgery and 46 patients who underwent conventional open surgery for anus preserved radical rectal cancer in Yangzhou University Affiliated Hospital between October 2014 and October 2018.The intraoperative operation,intraoperative and postoperative complications and recovery of digestive tract function were compared between the two procedures,and the advantages and disadvantages of the two procedures were analyzed to provide different surgical options for different patients in the future.reference.Results:The average operation time of the laparoscopic group and the open group was 248.19±43.58min and 179.24±36.48min,and the P value was less than 0.05.The difference was statistically significant.The operation time of the two groups is:laparoscopic group>open group.The average intraoperative blood loss in the laparoscopic group and the open group was 78.79±64.70ml and 139.13±57.65ml,and the P value was less than 0.05.The difference was statistically significant.The average intraoperative blood loss in the two groups was:laparoscopic group<open group.The frequency of postoperative analgesic drugs in the laparoscopic group and the open group was 0.81±1.18 times and 2.85±4.00 times.The P value was less than 0.05 and the difference was statistically significant.The degree of postoperative pain in patients:laparoscopic group<open group.The average postoperative intestinal function recovery time in the laparoscopic group and the open group was 4.36±1.42d and 5.02±1.29d.The P value was less than 0.05 and the difference was statistically significant.The average postoperative recovery of intestinal function in the two groups was:laparoscopic group<open group.The average postoperative hospital stay in the laparoscopic group and the open group was 14.23±6.76d and 18.93±9.18d.The P value was less than 0.05 and the difference was statistically significant.The average length of stay in the two groups was:laparoscopic group<open group.In the two groups,8 cases of abdominal infection occurred in the laparoscopic group,the incidence rate was 13.8%(8/58);1 case of wound infection occurred,the incidence rate was 5.2%(3/58);3 cases of pulmonary infection,incidence 5.2%(3/58);3 cases of anastomotic leakage,the incidence rate was 5.2%(3/58);3 cases of anastomotic bleeding,the incidence rate was 5.2%(3/58);2 cases of urinary dysfunction occurred The rate was 3.4%(2/58);0 case of deep vein thrombosis,the incidence rate was 0%(0/58).In the open group,12 cases of abdominal infection occurred,the incidence rate was 26.1%(12/46);5 cases of wound infection,the incidence rate was 10.9%(5/46);4 cases of pulmonary infection,the incidence rate was 8.7%(4/46));1 case of urinary tract infection,the incidence rate was 2.2%(1/46);4 cases of anastomotic leakage were 8.7%(4/46);3 cases of anastomotic hemorrhage,the incidence rate was 6.5%(3/46);1 case of intestinal obstruction,the incidence rate was 2.2%(1/46);2 cases of urinary dysfunction,the incidence rate was 4.3%(2/46);0 cases of deep vein thrombosis,the incidence rate was 0%(0/46).A comparative analysis of the chi-square test of the above-mentioned postoperative complications was performed.The P values were all greater than 0.05,and the difference was not statistically significant.52 patients in the laparoscopic group were satisfied with the postoperative condition,6 patients were dissatisfied,39 patients in the open group were satisfied with the postoperative condition,7 patients were not satisfied,the X2 value was 0.557,and the P value was greater than 0.05.The difference was not statistically significant,ie there was no significant difference in satisfaction between the two groups of patients.However,in the total number of complications,the total number of complications in the laparoscopic group was 11 and the open group was 19.The chi-square test showed that the X2 value was 6.237,and the P value was 0.013,less than 0.05.The difference was statistically significant.Significance,so in the total incidence of complications:laparoscopic group<open group.The number of lymph node dissections in the laparoscopic group and the open group was 12.52±4.67 and 12.74±3.71.The P value was greater than 0.05 and the difference was not statistically significant.The number of local recurrences in the laparoscopic group was 4,and the number of local recurrences in the open group was 3,with an X2 value of 0.006 and a P value greater than 0.05.The difference was not statistically significant.The anus function of the patients in the laparoscopic group and the open group was 7.24±3.74,8.62±3.79,and the P value was greater than 0.05.The difference was not statistically significant.Conclusion:Laparoscopic radical resection of rectal cancer is a commonly used surgical treatment for rectal cancer.Compared with open surgery,it has short operation time,less intraoperative blood loss,quick recovery of postoperative intestinal function,less pain,and hospitalization time.Short-term,less postoperative complications,short-term efficacy is better than open surgery,and the radical operation and safety of surgery is comparable to open surgery.However,the cost of laparoscopic surgery is higher than that of open surgery.In summary,laparoscopic radical resection of rectal cancer can be used as the preferred surgical method for rectal cancer patients with anal sphincter preservation,which is worthy of clinical promotion and application.Of course,in clinical practice,the choice of surgical methods needs to be combined with the patient’s individual condition and economic situation,comprehensive consideration and evaluation,to provide patients with more appropriate surgical methods.