目的 探讨腹腔镜辅助治疗直肠癌手术与传统开腹方法的安全性及远期疗效的差异。方法 回顾性分析从2010年1月到2013年1月本院收治的直肠癌根治患者297例。根据患者手术时自愿选择的手术方式将其分为腹腔镜组和开腹组，其中腹腔镜组129例，开腹组168例。手术后随访检查，比较两组手术的基本情况（手术时间、术中出血量、住院时间）、安全性（淋巴结清扫数量）和1年、3年的远期疗效（局部复发率、远端转移率、生存率、无瘤生存率）。结果 腹腔镜手术较传统开腹手术的术中出血量少、住院时间短（P<0.05）；手术时间和淋巴结清扫数量方面差别无统计学意义（P>0.05）。远期疗效中两组患者的复发率、转移率、生存率、无瘤生存率差别均无统计学意义(P>0.05)。结论 腹腔镜直肠癌根治手术在近期效果上较传统开腹手术有优势，而远期疗效上又能达到与开腹手术相同的疗效，不会增加直肠癌的复发率和转移率，值得推广。

Objective To explore the difference between laparoscopic assisted operation and traditional open operation in the treatment of rectal cancer. Methods A retrospective analysis in 297 patients with rectal cancer was carried out. The patients were divided into laparoscopic group (129 cases) and laparotomy group (168 cases) based on the operation mode. Follow up examination after operation were compared between the two groups, The basic situation of the operation such as operation time, amount of bleeding, hospitalization time and the amount of lymph node dissection were followed up. The one year and three years of long term effect such as the local recurrence rate, distant metastasis rate, survival rate and disease free survival rate were compared between two groups. Results The hemorrhage and hospitalization time in laparoscopic operation group were superior to those in laparotomy group (P<0.05), but there were no significantly difference on operation time and the amount of lymph node dissection between two groups (P>0.05). There were no significant difference on long term curative effect of recurrence rate, metastasis rate, survival rate, tumor free survival rate between two groups (P>0.05). Conclusion The laparoscopic radical resection of rectal carcinoma operation has the advantage in the near future effect and long-term therapeutic effect, and can achieve the same effect with open operation. It does not increase the rate of recurrence and metastasis of rectal cancer, and worthy of promotion.