Ju Haixing, Huang Xin, Zhu Yuping, Feng Haiyang, Li Dechuan
Department of Colorectal Cancer Surgery, Zhejiang Cancer Hospital, Hangzhou 310022, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2014 Jun;17(6):574-7.
The aim of this study was to compare the short-term outcomes for hand-assisted, laparoscopic, and open resection for rectal cancer.
Three hundred ninety patients with rectal cancer who underwent curative resection between June 2009 and June 2012 were included. Patients were classified into a hand-assisted group (HALS, n=101), a laparoscopic surgery group (LS, n=157), and an open surgery group (OS, n=132). Patient and disease characteristics, operative parameters, postoperative morbidity, pathological results and length of recovery were compared among three groups.
The mean operating time was (173±39) min for the HALS group, (231±61) min for the LS group, and (173±39) min for the OS group (P<0.01). Conversion rates did not differ between HALS and LS groups (2.0% vs 3.2%, P=0.708). The overall complication rates were 11.9%, 11.5%, and 19.7% in the HALS, LS and OS groups respectively (P=0.100). The specimen quality with a specimen length, distal resection margin, harvested lymph nodes, and positive lymph nodes did not differ among the three groups. Patients in the HALS and LS groups recovered significantly faster than those from the OS group.
This comparative study shows that HALS and LS can reproduce the equivalent short-term results of standard OS. HALS retained the minimal invasive advantages of LS, and significantly shorten the operation time.
本研究旨在比较直肠癌手辅助腹腔镜手术、腹腔镜手术及开放手术的短期疗效。
纳入2009年6月至2012年6月间接受根治性切除术的390例直肠癌患者。患者分为手辅助组（HALS，n = 101）、腹腔镜手术组（LS，n = 157）和开放手术组（OS，n = 132）。比较三组患者的临床和疾病特征、手术参数、术后发病率、病理结果及恢复时间。
HALS组平均手术时间为（173±39）分钟，LS组为（231±61）分钟，OS组为（173±39）分钟（P<0.01）。HALS组与LS组的中转率无差异（2.0%对3.2%，P = 0.708）。HALS组、LS组和OS组的总体并发症发生率分别为11.9%、11.5%和19.7%（P = 0.100）。三组间标本长度、远端切缘、获取淋巴结数及阳性淋巴结数等标本质量无差异。HALS组和LS组患者恢复明显快于OS组。
本对比研究表明，HALS和LS可取得与标准OS相当的短期疗效。HALS保留了LS的微创优势，并显著缩短了手术时间。
