| 摘要: |
| ［摘要］ 目的 观察腹部无辅助切口腹腔镜括约肌间切除治疗超低位直肠癌的临床疗效。方法 选取该院2016-06～2018-06收治的超低位直肠癌患者37例，依据所采取的手术方式的不同分为腹腔镜手术组20例，开腹手术组17例。腹腔镜手术组患者行腹部无辅助切口腹腔镜括约肌间切除术，开腹手术组患者行传统开腹手术治疗。比较两组患者手术时间、术中失血量、术后排气时间、首次进流质时间、术后住院时间以及淋巴结清扫数目。结果 腹腔镜手术组手术时间比开腹手术组延长(P<0.05)，术中失血量、术后排气时间、首次进流质时间、术后住院时间均少于或短于开腹手术组(P<0.05)。两组患者淋巴结清扫的数目差异无统计学意义(P>0.05)。腹腔镜手术组和开腹手术组手术并发症发生率分别为5.00%和29.41%，差异有统计学意义(P<0.05)。结论 腹部无辅助切口腹腔镜括约肌间切除治疗超低位直肠癌安全可行，并且具有出血量少、术后康复快等微创优势，清扫淋巴结数目和开腹手术相当，符合肿瘤根治原则，近期疗效肯定。 |
| 关键词: 括约肌间切除术 腹腔镜 开腹手术 淋巴结清扫 |
| DOI：10.3969/j.issn.1674-3806.2019.07.16 |
| 分类号:R 735. 3+7 |
| 基金项目: |
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| Curative effect of laparoscopic intersphincterectomy without auxiliary incision on ultra-low rectal cancer |
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FEI Qiang, HUANG You-ling, LU Wen-xian
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Department of Oncology Surgery, NO.371 Central Hospital of Chinese People′s Liberation Army, Henan 453000, China
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| Abstract: |
| ［Abstract］ Objective To analyze the curative effect of laparoscopic intersphincterectomy without auxiliary incision on ultra-low rectal cancer. Methods Thirty-seven patients with rectal cancer admitted to our hospital from June 2016 to June 2018 were divided into the laparoscopy group and the laparotomy group according to different operation methods, in which 20 patients underwent laparoscopic surgery(the laparoscopy group) while 17 patients underwent laparotomy(the laparotomy group). The laparoscopy group was treated with laparoscopic intersphincterectomy without auxiliary incision, and the laparotomy group received conventional open surgery. The operation time, intraoperative blood loss, exhaust time, first feed time and hospital stay after the operation, and the number of lymph node removed after operation were compared between the two groups. Results The operation time of the laparoscopy group was longer than that of the laparotomy group(P<0.05), the intraoperative blood loss, exhaust time, first feed time and hospital stay after operation in the laparoscopy group were less or shorter than those in the laparotomy group(P<0.05). There was no significant difference in the number of lymph nodes excised between the two groups(P>0.05). The incidence of surgical complications in the laparoscopy group and the laparotomy group was 5.00% and 29.41% respectively, and the difference was statistically significant between the two groups（P<0.05）. Conclusion Laparoscopic intersphincterectomy without auxiliary incision is safe and feasible for ultra-low rectal cancer, and the operation has minimally invasive advantages of less bleeding and fast recovery, and its short-term efficacy is positive. There is no significant difference in the number of resected lymph nodes between laparoscopy and laparotomy. |
| Key words: Intersphincteric resection Laparoscopy Laparotomy Lymphadenectomy |
