腹腔镜与开腹低位直肠癌Miles术的对比研究  

Clinical comparison of the laparoscopic and open Miles operation in low rectal carcinoma

作　　者：关心[1] 尚俊清[1] 孙跃明[2] 周欣[1] 周建农[1] 

机构地区：[1]南京医科大学附属江苏省肿瘤医院,江苏南京210009 [2]南京医科大学第一附属医院

出　　处：《腹腔镜外科杂志》2011年第11期816-818,共3页Journal of Laparoscopic Surgery

摘　　要：目的:探讨腹腔镜低位直肠癌Miles术的临床效果及应用价值。方法:回顾分析120例低位直肠癌Miles术患者的临床资料,其中腹腔镜组50例,遵循全直肠系膜切除原则行腹腔镜低位直肠癌Miles术;开腹组70例,行常规开腹手术。对比两组患者围手术期情况、淋巴结清扫数量、住院时间等指标。结果:两组标本直肠系膜均完整,腹腔镜组无一例中转开腹。腹腔镜组患者术后肠功能恢复快[(39.5±28.5)h vs.(52.4±12.2)h,P<0.05],住院时间短([11.0±5.4)d vs.(14.6±4.1)d,P<0.05]。手术时间、术中出血量及淋巴结清扫数量两组差异无统计学意义。术后无一例死亡及盆腔复发、穿刺孔种植转移。结论:腹腔镜低位直肠癌Miles术效果良好,具有患者创伤小、康复快等优点,值得推广应用。Objective：To assess the clinical effect of laparoseopic Miles operation tor low rectal cancer. Methods：The 120 pa- tients with low rectal carcinoma were included in a prospective non-randomized study. The patients were assigned to laparoscopic group （n =50） or open group （n= 70）. Perioperative outcomes, harvested lymph nodes and hospital stay were compared between the 2 groups. Results：The mesoreetum in resected specimen of 2 groups were intact,and no conversion from laparotomy to laparotomy was re- quired. An earlier recovery of bowel function was observed atier laparoscopic surgery [ （39.5 ± 28.5 ） h vs. （ 52.4±12.2 ） h ], p〈 0.05 ]. The hospital stay was shorter in laparoseopic group than laparotomy group[ （ 11.0±5.4） d vs. （ 14.6±4.1 ） d,P 〈 0.05 ]. Operative time,intraoperative blood loss and mean number of harvested lymph nodes in laparoscopie group were comparable to those in laparotomy group. No postoperative death and no pelvic recurrence were observed in the follow-up. No port site metastasis was regis- tered. Conclusions：The outcomes of this study suggest that taparoscopic Miles operation tor low rectal cancer is effective,mini-invasive and of quick recovery.

关 键 词：直肠肿瘤:Miles术 腹腔镜检查 剖腹术 对比研究 

分 类 号：R735.37[医药卫生—肿瘤]