Clinical Comparative Analysis Of Laparoscopic Resection For Rectal Cancer

Objective: This study reviewed the data of 651 cases of laparoscopic or open resection for rectal cancer in our hospital from 2010 to 2015,aimed to evaluate the safety and feasibility of such laparoscopic hysterectomy,the advantages and disadvantages of laparoscopic versus traditional open surgery and learning curve to the effect of rectal cancer.Methods: We collected the cases of rectal cancer in our hospital from 2010 to 2015,Inclusion criteria: Patients for the first time in the hospital for rectal cancer radical surgery.Before surgery,patients with colonoscopy and pathology confirmed the diagnosis of rectal cancer,without neoadjuvant radiotherapy,chemotherapy or other anti-tumor treatment.There is no history of malignant tumor and abdominal operation history.Postoperative pathology was confirmed as rectal cancer,and the patients without distant metastasis.According to the surgical approach and the number of operations performed by the different surgeons,15 patients were divided into the laparoscopic learning group(laparoscopic group A).The rest of laparoscopic surgery patients were included in the after laparoscopic learning group(laparoscopic group B),all open operation patients were divided into the open surgery.Comparison of the three groups between the clinical indicators,such as duration of surgery,intraoperative blood loss,number of lymph node dissection,anal exhaust time,hospitalization time and total cost of hospitalization,intraperitoneal drainage time,indwelling catheter time,postoperative complications and recent survival rate.The data were analyzed statistically.Results: By analyzing the statistical data of 651 patients,There were 387 male patients and 264 female patients with an average age of 61.87 ± 11.02 years.There were 480 patients were divided into the open surgery group.There were 60 patients in the laparoscopic learning curve who were divided into the laparoscopic group A.The remaining 111 laparoscopic cases were treated as laparoscopic group B.There were no significant differences in sex,age,number of lymph node dissection,CEA,preoperative hemoglobin,preoperative albumin,postoperative albumin and tumor location between the three groups(P>0.05).There were significant differences between the three groups in operation time and intraoperative blood loss(P<0.05).There was no significant difference between the laparoscopic group A and the open surgery group in blood transfusion(P>0.05).There were significant differences between the laparoscopic group AB and the open surgery group in anal exhaust time and total cost of hospitalization(P<0.05).There were significant differences between the laparoscopic group B and the open surgery group as well as between the laparoscopic group A and the laparoscopic group B in hospitalization time,intraperitoneal drainage time and indwelling catheter time(P<0.05).There were significant differences between the laparoscopic group B and the open surgery group in postoperative hemoglobin(P<0.05).The incidence of postoperative complications in the open surgery group was 63 and the incidence was 13.12%.Laparoscopic group B was 16 cases with an incidence of 16.67%.Laparoscopic group B was 13 cases with an incidence of 11.71%.Three groups of mortality were 0%.There was no significant difference in postoperative survival between the three groups(P> 0.05).Conclusion: Laparoscopic surgery and laparoscopic surgery both have a good effect.There was no significant difference in the three-year survival rate,but the laparoscopic abdominal wall incision is small,less bleeding surgery,shorter postoperative ventilation time,shorter indwelling catheter time,shorter hospitalization and so on.After learning the curve,the advantages of laparoscopic more obvious.In the case of a perfect preoperative assessment,the case of appropriate choice,laparoscopic rectal cancer Dixon surgery is effective,safe and feasible.