腹腔镜下全直肠系膜切除治疗中低位直肠癌的疗效  

Laparoscope-guided Total Mesorectal Excision in the Treatment of Mid- and Low Rectal Carcinoma：Observation on Therapeutic Effect

作　　者：杨海春[1] 杨忠祥[1] 张树峰[1] 于淑苹[1] 

机构地区：[1]黑龙江省大庆油田总医院,黑龙江大庆163001

出　　处：《中国肛肠病杂志》2011年第4期9-11,共3页Chinese Journal of Coloproctology

摘　　要：为探讨腹腔镜下全直肠系膜切除（TME）治疗中低位直肠癌的临床疗效，回顾行TME治疗的123例中低位直肠癌患者资料，其中66例于腹腔镜下行TME（观察组），57例开腹手术行TME（对照组），对比分析两组手术情况、患者术后恢复情况、围手术期并发症及标本肿瘤学指标等。结果显示，观察组手术时间比对照组长（P〈0．05）；但切口长度、术中出血量、术后VAS评分、肛门排气排便时问及围手术期并发症总发生率比较，观察组均优于对照组（P〈0．05），且观察组保肛率与对照组相近（P〉0．05）。两组标本的上下切缘均为阴性，标本长度和清除淋巴结数目比较差异均无统计学意义（P〉o．05）。随访至2010年8月，观察组患者术后性功能、排尿功能障碍发生率明显低于对照组（P〈0．05），两组在死亡、复发和转移方面差异均无统计学意义（P〉0．05）。结果表明，腹腔镜下TME治疗中低位直肠癌是安全、可行的，可以达到与传统开腹TME手术一样的远期疗效，且创伤小，患者痛苦小，恢复快。For the objective of investigating the clinical curative effect of laparoscope guided total mesorectal excision （TME） for midand low rectal carcinoma,author retrospectively analysed the data from the 123 patients who had been subiected to TME,among whom 66 patients to laparoscope-guided TME,as ob-servation group ; 57 patients to open-abdomen operation, as controlled group, compared and analyzed the op- eration condition of both groups,as well postoperative recovery status of patients,perioperative complica-tion and the specimen oncological indexes, etc. As results, in operative time observation group was longer than controlled group（ P 〉0. 05）, but in length of incision, amount of intraoperative bleeding, postoperative VAS score,exhaust and defecation time of anus, and total incidence of perioperative complication ob-servation group was all superior to controlled group（ P 〈0.05） ;in anus-saving rate observation group was closed with controlled group（ P 〉0.05） ;upper and lower incision edges of specimen of both groups were negative, and in length of specimen and the number of removed lymph nodes there was not statistical differ ence between both groups（ P 〉0.05）. The follow-up up to 2010-08 found that the incidences of postopera-tive sexual function and disturbance of urination in observation group were significantly lower than that in controlled group（ P 〈0.05）;in death,recurrence and metastasis of both groups there was not statistical difference（ P 〉0.05）. Results show that laparoscope-guided TME for mid- and low rectal carcinoma is safe and feasible;this procedure can achieve the same long-term therapeutic effect as that achieved by traditional open-abdomen operation,and its wound is less with milder pain and faster recovery.

关 键 词：中低位直肠癌 腹腔镜 全直肠系膜切除 疗效 

分 类 号：R735.37[医药卫生—肿瘤]