Comparison Between Laparoscopic And Open Miles Operation For Lower Rectal Carcinoma

Objective:The aim of this study was to investigate the value oflaparoscopic surgery in resection oflow rectal carcinoma， byretrospective comparing the postoperative curative effectbetweenlaparoscopic and open Milesoperation.Methods: from2010Februaryto2015February,33patients oflowrectal carcinoma have underwent Miles surgery inthe department ofgastrointestinalsurgery in our hospital.Among them,11patients whounderwentlaparoscopic surgerydefined as laparoscopic group and22patients who underwent open surgery defined as open group.Wecompared the differences between the two groups in operationtime,intraoperative bleeding,abdominal incision length,intestinalperistalsis recoverytime after operation,independent ambulationtime,hospitalization expenses, hospitalization time,postoperativecomplications(wound infection,pneumonia,lower extremityv einthrom-bosis,intestinalobstructionand dysfunctionof important organs),pathological data(number of lymph node dissectionandinvasion of operation margin).At the same time,wecompared the difference of thetwo groups in postoperative curative effect.Results:all the33patientsachieved the standard of tumor radicalresection.The abdominal incision length of Laparoscopic group andtheopen group(6.1667cm and17.75cm）and the independent ambulationtimeof two groups （5.333d and6.9d）, had statisticallysignificantdifference(P <0.05);The operation time (231.6minand237.1min),the amount of bleeding(235.3ml and256.7ml),intestinalperistalsisrecovery time(4.166dand4.6d),the hospitalization expenses（51212.69yuan and46504.38yuan）,the hospitalization time（32.1667dand27.40d），had no statistically significant difference(P>0.05).Theincidence of postoperative complicationsin laparoscopic group was5and the open group was18.The details are as follows, in thelaparoscopic group,1case ofcolostomystomacollapse,1case ofinfection,1case of ureteral injury,1case of pulmonary infection and1case of sacralanteriorincision infection;in open group,8cases ofincisioninfection,2cases of lunginfection,2cases of stoma necrosis orinfection,1case of heart failureafter operation,2cases of ureteral injuryand3cases of thrombosisof lower limb vein.The differences werestatistically significant(P <0.05).Pathological data of laparoscopicgroupand opengroup,the number of lymph nodewere19and17.47,thedifference between the two groupswere not statistically significant(P> 0.05).The patients of the two groups showed no invasion of tumor withpostoperativepathology.Conclusion:Laparoscopic and openMiles surgeryfor the treatmentof low rectal carcinomahave the same radical effects.Comparedwithopensurgery,Laparoscopic surgery has less trauma,beautifulincision,shorter recovery time,the lower occurrence of complications,andshould be actively carried out. But laparoscopic surgery has longeroperative time and higher cost.The skill levelis the most importantfactorto decide thetime of operation.