手助腹腔镜与腹腔镜辅助全直肠系膜切除的近期临床效果对比  

Short-term outcomes of radical resection of rectal carcinoma： hand-assisted laparoscopy versus traditional laparoscopic approach

作　　者：蒋会勇[1] 张雪峰[1] 王希泽[1] 李谨[1] 张成[1] 

机构地区：[1]沈阳军区总医院普通外科,110840

出　　处：《中华胃肠外科杂志》2012年第5期517-519,共3页Chinese Journal of Gastrointestinal Surgery

摘　　要：目的探讨手助腹腔镜（HALS）直肠癌全直肠系膜切除（TME）根治术的临床效果。方法选择沈阳军区总医院普通外科2010年1月至2011年3月期间住院手术的42例直肠癌患者，分别采用HALS（HALS组，19例）和腹腔镜辅助（腹腔镜辅助组。23例）进行TME直肠癌根治手术，并对两组患者的临床效果进行对比分析。结果两组患者手术均顺利完成。手术切缘均为阴性。HALS组和腹腔镜辅助组手术时间分别为（152±17）min和（168±19）min（t=2．767，P=0．009）；Dixon手术切口长度分别为中位数5．6em和4．512cm（P=0．000）；住院费用分别为2．6万元和2．9万元（P=0．008）：而术中失血量、清除淋巴结数、术后排气时间和住院时间两组差异无统计学意义（均P〉0．05）。结论HALS直肠癌TME根治术同样具备腹腔镜辅助手术微创、安全、术后恢复快和创伤小的优点。Objective To study the feasibility of hand-assisted laparoscopic radical resection of rectal carcinoma and compare the short-term outcomes of HALS versus traditional laparoscopy approach. Methods Clinical data of 42 cases of rectal carcinoma between January 2010 and March 2011 were enrolled in this study. Nineteen cases underwent HALS total mesorectal excision and 23 cases underwent traditional laparoscopy approach. Results All the operations were successfuUy accomplished without conversions to open surgery. The mean operation time of the HALS group was shorter than that of the traditional laparoscopic group （152 min vs. 168 min, P=O.009）. Incision length was significantly longer in the HALS group（5.6 cm vs. 4.5 cm, P=0.000）. The median overall costs were lower in HALS group （26 000 RMB vs. 29 000 RMB, P=0.008）. The number of lymph nodes in resected specimen, intraoperative blood loss, length of hospital stay, time to passage of flatus were comparable between the two groups. Conclusions Hand-assisted laparoscopic surgery has the advantages of laparoscopic surgery including minimal invasiveness, safety, and quicker postoperative recovery.

关 键 词：直肠肿瘤 全直肠系膜切除术 手助腹腔镜 腹腔镜 

分 类 号：R735.37[医药卫生—肿瘤]