腹骶联合直肠癌切除术的临床应用  

Clinical applications of abdominosacral resection for low rectal cancer

作　　者：高峰[1] 徐明[1] 赵勇[1] 周松涛[1] 任彦武[1] 宋枫[1] 吕志诚[1] 

机构地区：[1]兰州军区兰州总医院肛肠外科,:730050

出　　处：《中华胃肠外科杂志》2012年第10期1070-1072,共3页Chinese Journal of Gastrointestinal Surgery

摘　　要：目的探讨腹骶联合切除术治疗低位进展期直肠癌的可行性和安全性。方法前瞻性人组2010年6月至2012年1月间兰州军区兰州总医院收治的可行局部根治性切除但又难以保留肛门的97例低位进展期直肠癌患者，按人院顺序交替分为腹会阴组（49例，行腹会阴联合切除术）和腹骶组（48例，行腹骶联合切除术）。比较两组患者的术中及术后情况。结果两组患者手术顺利，无围手术期死亡。与腹会阴组相比，腹骶组手术时间（包括第2次调整体位的时间）明显延长[（188±45）min比（143±48）min，P=0．000]，非计划性前列腺或阴道损伤发生率降低[0比14．3％（7／49），P=0．032]，会阴部切口感染率降低[2．1％（1／48）比18．4％（9／49），P=0．040]。结论腹骶联合切除术应用于中低位直肠癌患者安全、可行。Objective To explore the feasibility and safety of abdominosacral resection for patients with locally advanced primary low rectal cancer. Methods A total of 97 low rectal cancer patients were amenable to surgery but not anal sphincter preservation were included in this study and divided into the abdominoperineal resection group （n=49） and abdominosacral resection group （n=48） according to the order of alternative admission time between June 2010 and January 2012. Intraoperative and postoperative parameters were compared between the two groups. Results The surgery went well and no perioperative mortality in the two groups. Compared with abdominoperineal resection group, the operative time of abdominosacral resection group（including the 2nd position adjustment time） was longer [ （188±45） min vs. （143±48） min, P=0.000], the unexpected prostate or vagina injury incidence was lower [0 vs. 14.3%（7/49）, P=0.032）, and the perineal wound infection rate was lower [2.1% （1/48） vs. 18.4% （9/49）, P=0.040]. Conclusion Abdominosacral excision is feasible and safe for patients with locally advanced primary low rectal cancer.

关 键 词：直肠肿瘤 腹骶联合切除术 腹会阴联合切除术 

分 类 号：R735.37[医药卫生—肿瘤]