| 摘要: |
| 目的 探讨腹部无辅助切口腹腔镜括约肌间切除对超低位直肠癌的临床疗效。方法 选取2016—0 6～2018—0 6期间收治的超低位直肠癌患者 37 例,依据采取的手术方式分为腹腔镜与开腹组,腹腔镜组20例,开腹组17例。腹腔镜组病人行腹部无辅助切口腹腔镜括约肌间切除术,开腹组患者行传统开腹手术治疗,分析两组病人手术时间、术中出血量、排气时间、导尿管留置时间、术后住院时间以及淋巴结清扫数目。结果 腹腔镜组患者手术时间比开腹组延长( P ＜ 0. 05) ,术中出血量、术后排气时间、导尿管留置时间、术后住院时间均少于开腹组( P ＜ 0. 05) 。两组病人淋巴结清扫的数目差异无统计学意义( P ＞ 0. 05) 。手术并发症发生率方面,腹腔镜组与开腹组分别为 5.0% 、29.4% ,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,并且具有出血少、术后快速康复等微创优势,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 |
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| The clinic analysis of laparoscopic intersphincterectomy without auxiliary incision for ultra-low rectal cancer |
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371 Central Hospital of PLA
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| Abstract: |
| Objective To investigate the clinical effect of laparoscopic intersphincterectomy without auxiliary incision for ultra-low rectal cancer. Methods 37 patients with rectal cancer admitted to our hospital from June 2016 to June 2018 were divided into the laparoscopic group and the open group , in which 20 patients underwent laparoscopic surgery ( laparoscopy group) while 17 patients underwent open surgery( open surgery group). The laparoscopic group was treated with laparoscopic intersphincterectomy without auxiliary incision , and the open group conventional open surgery. the operation time, intraoperative blood loss, the exhaust time, indwelling catheter time and hospital stay after the operation,and numbers of lymph node removedafter operation were compared. Results The time of operation of the laparoscopic group was longer than that of the open group( P ＜ 0. 05), the intraoperative blood loss, the exhaust time, indwelling catheter time and hospital stay after the operation were less than those of the open group( P ＜ 0. 05), there was no significant difference between the two groups in the number of lymph nodes excised and the complication rate( P ＞ 0. 05) ; Compared with open group, laparoscopic group had lower complication rate. Conclusion Laparoscopic intersphincterectomy without auxiliary incision for ultra-low rectal cancer is safe and feasible. but the laparoscopic rectal resection has a less bleeding, fast recovery, It is no difference in amount of resected lymph nodes between laparoscopic and open gastrectomy. The short-term outcome has been confirmed. |
| Key words: Intersphincteric resection Laparoscopy Laparotomy Lymphadenectomy |
